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General NPI Number Information
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NPI Number | 1396271235
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Entity Type | Organization
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Legal Business Name | FAMILY EYECARE ALEXIS E SCATCHELL OD
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 5355 W DEVON AVE
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City | CHICAGO
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State | IL
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Zip | 60646-4142
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Country | US
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Telephone | 773-930-4035
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Fax |
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Provider Business Mailing Address
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Address Line | 5355 W DEVON AVE
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City | CHICAGO
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State | IL
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Zip | 60646-4142
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Country | US
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Telephone | 773-930-4035
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | ALEXANDRIA E SCATCHELL
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Credential |
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Telephone | 773-458-3230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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