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General NPI Number Information
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NPI Number | 1437385218
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Entity Type | Organization
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Legal Business Name | M.E.D.MIDWEST CARE HOME HEALTH SERVICES LLC
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Dates
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Enumeration Date | 06/07/2009
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Last Update Date | 06/07/2009
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Provider Practice Location Address
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Address Line | 2535 BERNICE RD
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City | LANSING
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State | IL
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Zip | 60438-1025
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Country | US
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Telephone | 708-474-6770
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Fax | 708-474-6747
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Provider Business Mailing Address
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Address Line | 2685 W 85TH AVE
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City | MERRILLVILLE
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State | IN
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Zip | 46410-6165
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Country | US
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Telephone | 219-738-2704
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR/MANAGER
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Name | MANELITA PRESTO DAYON
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Credential | R.N.
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Telephone | 708-474-6770
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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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