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General NPI Number Information
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NPI Number | 1497764518
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Entity Type | Individual
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Provider Name | MICHAEL N FORTSAS MD
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Gender | Male
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 27750 W HIGHWAY 22 STE 220
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City | BARRINGTON
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State | IL
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Zip | 60010-1924
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Country | US
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Telephone | 815-206-5700
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Fax | 847-382-1771
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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Country | US
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Telephone |
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Fax |
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 31700
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 036090812
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License Number State | IL
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