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General NPI Number Information
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NPI Number | 1639792476
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Entity Type | Individual
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Provider Name | KATHERINE MOSIO
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Gender | Female
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Dates
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Enumeration Date | 05/27/2020
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Last Update Date | 05/27/2020
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Provider Practice Location Address
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Address Line | 722 W MAXWELL ST STE 205
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City | CHICAGO
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State | IL
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Zip | 60607-5002
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Country | US
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Telephone | 312-355-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 4048 FAIRWAY DR
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City | WILMETTE
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State | IL
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Zip | 60091-1006
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Country | US
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Telephone | 847-962-1690
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Fax |
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 051287837
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License Number State | IL
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