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General NPI Number Information
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NPI Number | 1629235767
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Entity Type | Organization
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Legal Business Name | ALAN M. REICH
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 7447 W TALCOTT AVE SUITE 569
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City | CHICAGO
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State | IL
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Zip | 60631-3745
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Country | US
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Telephone | 177-377-5957
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Fax | 177-377-5971
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Provider Business Mailing Address
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Address Line | 7447 W TALCOTT AVE SUITE 569
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City | CHICAGO
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State | IL
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Zip | 60631-3745
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Country | US
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Telephone | 177-377-5957
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Fax | 177-377-5971
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Authorized Official
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Title or Position | OWNER
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Name | ALAN M. REICH
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Credential | M.D.
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Telephone | 17737759574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 036061772
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License Number State | IL
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