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NPI 1356760573

NPI 1356760573 : NORTH SHORE AESTHETICS PC : NORTHBROOK, IL

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General NPI Number Information
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    NPI Number           |    1356760573
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    Entity Type          |    Organization 
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    Legal Business Name  |    NORTH SHORE AESTHETICS PC 
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Dates
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    Enumeration Date     |    04/15/2014
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    Last Update Date     |    07/01/2014
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Provider Practice Location Address
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    Address Line         |    1404 TECHNY RD 
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    City                 |    NORTHBROOK
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    State                |    IL
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    Zip                  |    60062
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    Country              |    US
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    Telephone            |    847-393-4770
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    Fax                  |    224-326-2239
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Provider Business Mailing Address
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    Address Line         |    1404 TECHNY RD 
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    City                 |    NORTHBROOK
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    State                |    IL
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    Zip                  |    60062
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    Country              |    US
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    Telephone            |    847-393-4770
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    Fax                  |    224-326-2239
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. BENJAMIN  SCHLECHTER 
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    Credential           |    MD
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    Telephone            |    847-393-4770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208200000X
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    Taxonomy Name        |    Plastic Surgery Physician
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    License Number       |    
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    License Number State |    
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