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NPI 1740555333

NPI 1740555333 : ERIC MCILROY PT : DALLAS, TX

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General NPI Number Information
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    NPI Number           |    1740555333
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    Entity Type          |    Individual 
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    Provider Name        |    ERIC MCILROY PT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/14/2012
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    Last Update Date     |    03/03/2020
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Provider Practice Location Address
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    Address Line         |    7989 BELT LINE RD STE 90 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75248-5728
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    Country              |    US
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    Telephone            |    972-942-2475
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    Fax                  |    972-645-0687
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Provider Business Mailing Address
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    Address Line         |    600 OAKMONT LN STE 600C 
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    City                 |    WESTMONT
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    State                |    IL
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    Zip                  |    60559-5548
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    Country              |    US
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    Telephone            |    630-575-6250
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    Fax                  |    630-575-7450
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    1131142
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    License Number State |    TX
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