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General NPI Number Information
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NPI Number | 1619221835
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Entity Type | Organization
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Legal Business Name | OPTIMAL HEALING, INC.
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Dates
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Enumeration Date | 11/09/2012
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 2202 N LINCOLN AVE SUITE #1
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City | CHICAGO
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State | IL
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Zip | 60614-7170
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Country | US
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Telephone | 312-448-8122
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Fax | 773-248-2058
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Provider Business Mailing Address
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Address Line | 2202 N LINCOLN AVE SUITE #1
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City | CHICAGO
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State | IL
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Zip | 60614-7170
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Country | US
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Telephone | 312-448-8122
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Fax | 773-248-2058
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. MINA H. PATEL
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Credential | DC
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Telephone | 312-448-8122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 038012243
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 038012243
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License Number State | IL
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