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General NPI Number Information
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NPI Number | 1356590517
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Entity Type | Organization
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Legal Business Name | RAKHSHANDA M. MUNIR MD SC
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 10/06/2008
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Provider Practice Location Address
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Address Line | 4438 N MILWAUKEE AVE
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City | CHICAGO
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State | IL
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Zip | 60630-3743
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Country | US
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Telephone | 773-794-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 4438 N MILWAUKEE AVE
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City | CHICAGO
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State | IL
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Zip | 60630-3743
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Country | US
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Telephone | 773-794-2100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAKHSHANDA M. MUNIR
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Credential | MD
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Telephone | 773-794-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 036094551
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License Number State | IL
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