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General NPI Number Information
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NPI Number | 1760597140
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Entity Type | Individual
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Provider Name | JOEL G. BRASCH MD
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Gender | Male
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 10811 W 143RD ST SUITE 120
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City | ORLAND PARK
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State | IL
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Zip | 60467-1913
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Country | US
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Telephone | 708-403-4210
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Fax | 708-403-5272
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Provider Business Mailing Address
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Address Line | 5225 OLD ORCHARD RD SUITE 10
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City | SKOKIE
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State | IL
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Zip | 60077-4405
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Country | US
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Telephone | 847-966-8815
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Fax | 847-966-8305
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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 | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | 01041509A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number |
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License Number State | IL
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