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General NPI Number Information
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NPI Number | 1568921898
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Entity Type | Individual
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Provider Name | JOSHUA WILLIAM LORENZ MD
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Gender | Male
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Dates
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Enumeration Date | 03/16/2019
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 1801 W TAYLOR ST
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City | CHICAGO
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State | IL
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Zip | 60612-4795
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Country | US
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Telephone | 312-996-3631
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Fax |
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Provider Business Mailing Address
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Address Line | 150 HARVESTER DR STE 300
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City | BURR RIDGE
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State | IL
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Zip | 60527-5965
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 036167887
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License Number State | IL
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