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General NPI Number Information
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NPI Number | 1598563801
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Entity Type | Organization
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Legal Business Name | ADVOCATE CONDELL MEDICAL CENTER
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 900 GARFIELD AVE
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-3141
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Country | US
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Telephone | 847-990-5146
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 208
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City | SHEBOYGAN
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State | WI
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Zip | 53082-0208
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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 | VP MANAGED HEALTH
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Name | KARA RICHARDSON
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Credential |
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Telephone | 980-416-4068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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