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General NPI Number Information
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NPI Number | 1376619833
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Entity Type | Individual
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Provider Name | ABDELRAOUF M OUBAID MD
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Gender | Male
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 01/22/2014
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Provider Practice Location Address
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Address Line | 1845 W 47TH ST
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City | CHICAGO
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State | IL
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Zip | 60609-3844
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Country | US
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Telephone | 773-927-5524
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Fax |
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Provider Business Mailing Address
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Address Line | 8934 S MEADE AVE
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City | OAK LAWN
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State | IL
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Zip | 60453
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Country | US
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Telephone | 708-560-4698
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036047037
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License Number State | IL
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