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NPI 1588997530

NPI 1588997530 : ABSOLUTE-GEM REHAB, INC. : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1588997530
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    Entity Type          |    Organization 
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    Legal Business Name  |    ABSOLUTE-GEM REHAB, INC. 
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Dates
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    Enumeration Date     |    09/09/2009
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    Last Update Date     |    09/09/2009
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Provider Practice Location Address
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    Address Line         |    5440 N CUMBERLAND AVE SUITE 101B
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60656-1490
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    Country              |    US
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    Telephone            |    773-777-6168
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    Fax                  |    773-751-2031
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Provider Business Mailing Address
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    Address Line         |    5440 N CUMBERLAND AVE SUITE 101B
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60656-1490
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    Country              |    US
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    Telephone            |    773-777-6168
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    Fax                  |    773-751-2031
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Authorized Official
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    Title or Position    |    ADMINISTRATOR
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    Name                 |     MONINA  CANETE 
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    Credential           |    
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    Telephone            |    773-777-6168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    
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    License Number State |    
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