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General NPI Number Information
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NPI Number | 1558436329
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Entity Type | Individual
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Provider Name | ANDRES VERA MD
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 855 E GOLF RD STE 2133
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-5222
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Country | US
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Telephone | 847-290-9122
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Fax | 847-290-9133
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Provider Business Mailing Address
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Address Line | 2814 N. MILWAUKEE AVE
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City | CHICAGO
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State | IL
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Zip | 60618-7272
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Country | US
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Telephone | 773-216-8372
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Fax | 773-276-0333
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 36057483
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License Number State | IL
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