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General NPI Number Information
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NPI Number | 1538423371
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Entity Type | Individual
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Provider Name | ALLISON HONART WEST DEPERSIA MD
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Gender | Female
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Dates
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Enumeration Date | 06/26/2012
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Last Update Date | 04/01/2021
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Provider Practice Location Address
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Address Line | 1000 CENTRAL ST. SUITE 610
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City | EVANSTON
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State | IL
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Zip | 60201
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Country | US
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Telephone | 847-570-1029
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Fax | 847-503-4356
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Provider Business Mailing Address
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Address Line | 1000 CENTRAL ST. SUITE 610
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City | EVANSTON
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State | IL
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Zip | 60201-1780
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Country | US
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Telephone | 847-570-1029
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Fax | 847-503-4356
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 036137170
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036137170
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License Number State | IL
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