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General NPI Number Information
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NPI Number | 1316141849
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Entity Type | Individual
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Provider Name | SHERRY D SIMMONS M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4525 WABASH AVE SUITE 2
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City | SPRINGFIELD
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State | IL
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Zip | 62711-7037
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Country | US
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Telephone | 217-698-8607
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Fax | 217-698-8643
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Provider Business Mailing Address
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Address Line | 2609 PARSLEY LN
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City | SPRINGFIELD
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State | IL
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Zip | 62711-7027
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Country | US
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Telephone | 217-698-8607
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Fax | 217-698-8643
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | IL
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