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General NPI Number Information
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NPI Number | 1780870410
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Entity Type | Organization
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Legal Business Name | ALAM S. MD, LLC
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Dates
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Enumeration Date | 09/17/2007
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Last Update Date | 11/20/2007
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Provider Practice Location Address
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Address Line | 1200 W SOUTH ST
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City | PLANO
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State | IL
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Zip | 60545-1790
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Country | US
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Telephone | 630-552-8826
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Fax | 630-552-0236
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Provider Business Mailing Address
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Address Line | ALAM S MD LLC PO BOX 606
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City | MONTGOMERY
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State | IL
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Zip | 60538-0606
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Country | US
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Telephone | 630-552-8826
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Fax | 630-552-0236
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAROOR ALAM
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Credential | MD
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Telephone | 630-552-8826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | IL
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