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General NPI Number Information
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NPI Number | 1679507628
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Entity Type | Organization
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Legal Business Name | MULTISPECIALTY MEDICAL CENTER LTD
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 333 CHESTNUT ST SUITE 205
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City | HINSDALE
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State | IL
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Zip | 60521-3247
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Country | US
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Telephone | 630-323-7096
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Fax | 630-323-7531
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Provider Business Mailing Address
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Address Line | 40 S CLAY ST SUITE 246E
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City | HINSDALE
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State | IL
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Zip | 60521-3257
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Country | US
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Telephone | 630-323-7096
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Fax | 630-323-7531
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. DREW S KANDILAKIS
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Credential | D.C.
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Telephone | 630-323-7096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 042-618356
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License Number State | IL
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