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General NPI Number Information
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NPI Number | 1720138308
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Entity Type | Individual
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Provider Name | JEFFREY J. CIOLINO M.A., L.C.P.C.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4755 N KENMORE AVE
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City | CHICAGO
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State | IL
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Zip | 60640-5015
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Country | US
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Telephone | 773-905-9805
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Fax |
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Provider Business Mailing Address
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Address Line | 701 W BITTERSWEET PL #3
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City | CHICAGO
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State | IL
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Zip | 60613-2309
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Country | US
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Telephone | 773-905-9805
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | IL
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