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General NPI Number Information
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NPI Number | 1740191766
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Entity Type | Organization
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Legal Business Name | BRISTOL HOSPICE - CHICAGO, L.L.C.
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Dates
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Enumeration Date | 09/16/2026
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Last Update Date | 09/16/2026
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Provider Practice Location Address
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Address Line | 51 W JACKSON ST STE 230
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City | JOLIET
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State | IL
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Zip | 60432-1729
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Country | US
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Telephone | 815-296-5150
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Fax | 815-620-3002
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Provider Business Mailing Address
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Address Line | 206 N 2100 W STE 202
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City | SALT LAKE CITY
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State | UT
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Zip | 84116-4741
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Country | US
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Telephone | 801-325-0175
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | ALEX MAURICIO
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Credential |
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Telephone | 801-325-0175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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