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General NPI Number Information
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NPI Number | 1659320133
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Entity Type | Individual
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Provider Name | ESTELLE SHIRLEY FLETCHER MD, PHD
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Gender | Female
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 01/23/2008
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Provider Practice Location Address
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Address Line | 99- 129TH INFANTRY DRIVE
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City | JOLIET
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State | IL
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Zip | 60435-5134
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Country | US
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Telephone | 815-744-3335
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Fax | 815-744-3701
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Provider Business Mailing Address
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Address Line | 99- 129TH INFANTRY DRIVE
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City | JOLIET
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State | IL
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Zip | 60435-5134
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Country | US
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Telephone | 815-744-3335
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Fax | 815-744-3701
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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 | 036-089471
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License Number State | IL
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