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General NPI Number Information
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NPI Number | 1669485777
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Entity Type | Organization
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Legal Business Name | CENTER FOR NEUROLOGICAL DISORDERS S,C
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 06/05/2018
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Provider Practice Location Address
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Address Line | 5600 W ADDISON ST SUITE 406
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City | CHICAGO
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State | IL
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Zip | 60634
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Country | US
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Telephone | 773-205-9800
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Fax | 773-205-9801
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Provider Business Mailing Address
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Address Line | PO BOX 320
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City | GLENVIEW
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State | IL
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Zip | 60025-0320
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Country | US
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Telephone | 847-400-5540
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PRASAD CHAPPIDI
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Credential | M.D.
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Telephone | 773-205-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036097660
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License Number State | IL
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