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General NPI Number Information
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NPI Number | 1407079197
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Entity Type | Organization
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Legal Business Name | NETWORK MEDICAL REVIEW COMPANY LTD
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 605 FULTON AVE SUITE 2002
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City | ROCKFORD
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State | IL
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Zip | 61103-4179
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Country | US
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Telephone | 815-964-6334
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Fax | 815-964-1162
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Provider Business Mailing Address
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Address Line | 605 FULTON AVE SUITE 2002
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City | ROCKFORD
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State | IL
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Zip | 61103-4179
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Country | US
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Telephone | 815-964-6334
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Fax | 815-964-1162
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Authorized Official
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Title or Position | CEO PRESIDENT
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Name | DR. ROBERT CHARLES PORTER
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Credential | MD
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Telephone | 815-964-6334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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