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General NPI Number Information
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NPI Number | 1750709630
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Entity Type | Organization
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Legal Business Name | ST. MARY'S HOSPITAL
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Dates
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Enumeration Date | 03/28/2014
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Last Update Date | 03/28/2014
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Provider Practice Location Address
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Address Line | 111 SPRING ST
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City | STREATOR
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State | IL
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Zip | 61364-3332
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Country | US
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Telephone | 815-673-4549
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Fax |
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Provider Business Mailing Address
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Address Line | 111 SPRING ST
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City | STREATOR
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State | IL
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Zip | 61364-3332
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Country | US
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Telephone | 815-673-4549
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MRS. MEGAN JEANNE ROWE
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Credential | DPT
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Telephone | 815-252-5231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | 070.020537
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License Number State | IL
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