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General NPI Number Information
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NPI Number | 1316401037
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Entity Type | Organization
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Legal Business Name | ADVOCATE HEALTH CARE NETWORK
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Dates
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Enumeration Date | 01/27/2019
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Last Update Date | 01/27/2019
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Provider Practice Location Address
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Address Line | 4900 MAIN ST
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-3611
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Country | US
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Telephone | 630-963-5440
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 MAIN ST
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-3611
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SURGICAL DIRECTOR
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Name | GRANT SMITH
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Credential |
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Telephone | 630-963-5440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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