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General NPI Number Information
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NPI Number | 1316055536
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Entity Type | Organization
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Legal Business Name | M MICHAEL FORUTAN MD SC
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 600 S WASHINGTON ST STE 300
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City | NAPERVILLE
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State | IL
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Zip | 60540-6667
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Country | US
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Telephone | 630-717-7000
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Fax | 630-717-7011
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Provider Business Mailing Address
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Address Line | PO BOX 3911
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City | LISLE
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State | IL
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Zip | 60532-8911
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Country | US
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Telephone | 630-717-7000
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Fax | 630-717-7011
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Authorized Official
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Title or Position | OWNER
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Name | DR. MANUCHER MICHAEL FORUTAN
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Credential | MD
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Telephone | 630-717-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | IL
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