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General NPI Number Information
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NPI Number | 1316181183
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Entity Type | Organization
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Legal Business Name | RESURRECTION WESTLAKE HOSPITAL
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Dates
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Enumeration Date | 04/23/2009
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Last Update Date | 04/23/2009
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Provider Practice Location Address
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Address Line | 7311 W MONTROSE AVE
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City | NORRIDGE
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State | IL
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Zip | 60706-1157
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Country | US
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Telephone | 773-633-3665
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Fax |
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Provider Business Mailing Address
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Address Line | 7311 W MONTROSE AVE
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City | NORRIDGE
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State | IL
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Zip | 60706-1157
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Country | US
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Telephone | 773-633-3665
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | DR. VIJAY YELDANDI
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Credential | M.D.
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Telephone | 708-938-7880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number |
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License Number State |
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