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General NPI Number Information
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NPI Number | 1336916477
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Entity Type | Individual
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Provider Name | JILL R. PATEL
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Gender | Female
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Dates
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Enumeration Date | 12/08/2023
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 142-E S RANDALL RD.
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City | BARTLETT
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State | IL
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Zip | 60134
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Country | US
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Telephone | 331-248-1321
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 LONGFORD RD
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City | BARTLETT
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State | IL
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Zip | 60103-1912
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Country | US
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Telephone | 630-864-0338
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209028928
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041495188
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License Number State | IL
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