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General NPI Number Information
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NPI Number | 1649459116
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Entity Type | Organization
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Legal Business Name | KATARZYNA MENCEL M.D.S.C.
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 7740 W NORTH AVE
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City | ELMWOOD PARK
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State | IL
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Zip | 60707-4124
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Country | US
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Telephone | 708-456-3200
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Fax | 708-456-3437
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Provider Business Mailing Address
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Address Line | 7740 W NORTH AVE
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City | ELMWOOD PARK
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State | IL
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Zip | 60707-4124
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Country | US
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Telephone | 708-456-3200
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Fax | 708-456-3437
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Authorized Official
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Title or Position | OWNER
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Name | KATHRYN J MENCEL
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Credential | M.D.
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Telephone | 708-456-3200
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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 | 036-103885
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License Number State | IL
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