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General NPI Number Information
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NPI Number | 1659510998
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Entity Type | Organization
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Legal Business Name | ANGELO SOYANGCO,M.D.
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Dates
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Enumeration Date | 02/10/2009
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Last Update Date | 02/10/2009
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Provider Practice Location Address
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Address Line | 834 N SEMINARY ST STE 401
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City | GALESBURG
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State | IL
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Zip | 61401-2852
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Country | US
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Telephone | 309-343-5583
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Fax | 309-343-4276
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Provider Business Mailing Address
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Address Line | 834 N SEMINARY ST STE 401
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City | GALESBURG
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State | IL
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Zip | 61401-2852
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Country | US
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Telephone | 309-343-5583
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Fax | 309-343-4276
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANGELO J SOYANGCO
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Credential | MD
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Telephone | 309-343-5583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 036085833
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License Number State | IL
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