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General NPI Number Information
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NPI Number | 1639582562
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Entity Type | Individual
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Provider Name | ANDREW SKOLARZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2014
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Last Update Date | 05/20/2019
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Provider Practice Location Address
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Address Line | 7447 W TALCOTT AVE STE 366
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City | CHICAGO
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State | IL
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Zip | 60631
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Country | US
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Telephone | 773-594-1410
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Fax | 773-774-1402
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Provider Business Mailing Address
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Address Line | 7447 W TALCOTT AVE STE 366
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City | CHICAGO
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State | IL
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Zip | 60631-3719
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Country | US
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Telephone | 773-594-1410
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Fax | 773-774-1402
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036.148237
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License Number State | IL
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