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General NPI Number Information
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NPI Number | 1346779196
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Entity Type | Individual
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Provider Name | TAYLOR STEVENSON ELSER MD
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Gender | Female
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 301 MADISON ST STE 307
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City | JOLIET
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State | IL
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Zip | 60435-6665
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Country | US
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Telephone | 630-545-7565
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 713260
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City | CHICAGO
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State | IL
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Zip | 60677-1260
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Country | US
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Telephone | 630-469-9200
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 51179
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 036-171187
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License Number State | IL
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