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General NPI Number Information
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NPI Number | 1427057744
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Entity Type | Individual
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Provider Name | TRAM L LUU M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 11/25/2009
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Provider Practice Location Address
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Address Line | 1030 N CLARK ST SUITE 400
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City | CHICAGO
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State | IL
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Zip | 60610-5467
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Country | US
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Telephone | 312-943-6964
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Fax | 312-943-6924
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Provider Business Mailing Address
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Address Line | PO BOX 189
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City | MATTESON
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State | IL
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Zip | 60443-0189
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Country | US
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Telephone | 708-747-5850
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Fax | 708-747-9991
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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 | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 036102831
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License Number State | IL
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