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General NPI Number Information
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NPI Number | 1679908396
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Entity Type | Organization
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Legal Business Name | K MEDICAL PC
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Dates
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Enumeration Date | 09/12/2013
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 3631 N HARLEM AVE
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City | CHICAGO
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State | IL
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Zip | 60634-2237
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Country | US
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Telephone | 773-895-3668
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Fax | 708-933-3000
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Provider Business Mailing Address
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Address Line | 511 HIGHVIEW DR
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City | FOX RIVER GROVE
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State | IL
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Zip | 60021-1107
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Country | US
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Telephone | 773-895-3668
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Fax | 708-933-3000
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAREN HUNT
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Credential | DPM
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Telephone | 773-895-3668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 016-004758
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License Number State | IL
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