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General NPI Number Information
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NPI Number | 1659102713
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Entity Type | Individual
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Provider Name | PALLAVI RANGAN MBBS
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Gender | Female
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Dates
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Enumeration Date | 08/12/2024
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 2160 S 1ST AVE BLDG 110
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone | 708-327-2547
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Fax |
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Provider Business Mailing Address
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Address Line | 2640 N AVONDALE AVE UNIT G
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City | CHICAGO
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State | IL
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Zip | 60647-6401
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Country | US
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Telephone | 551-349-5074
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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 | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number | 125.084977
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 125084977
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 125.084977
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License Number State | IL
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