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General NPI Number Information
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NPI Number | 1639696073
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Entity Type | Individual
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Provider Name | BOYCE N MOFFITT OPTICIAN, ABOC
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Gender | Male
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Dates
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Enumeration Date | 08/26/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 12 E 1ST ST
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City | HINSDALE
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State | IL
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Zip | 60521-4102
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Country | US
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Telephone | 630-325-2020
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Fax | 312-275-7189
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Provider Business Mailing Address
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Address Line | 1205 N DEARBORN ST
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City | CHICAGO
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State | IL
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Zip | 60610-2213
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Country | US
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Telephone | 312-943-2020
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Fax | 312-275-7189
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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