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General NPI Number Information
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NPI Number | 1396861159
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Entity Type | Organization
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Legal Business Name | OPTIMUM PROFESSIONALS HOME HEALTH CARE INC.
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 12/23/2011
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Provider Practice Location Address
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Address Line | 3520 S MORGAN ST.
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City | CHICAGO
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State | IL
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Zip | 60609-5655
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Country | US
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Telephone | 773-847-3220
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Fax | 773-847-3828
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Provider Business Mailing Address
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Address Line | 3520 S MORGAN ST FL 2
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City | CHICAGO
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State | IL
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Zip | 60609-1524
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Country | US
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Telephone | 773-847-3220
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Fax | 773-847-3828
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LOIDA E RAYA
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Credential | REGISTERED NURSE
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Telephone | 773-847-3220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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