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General NPI Number Information
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NPI Number | 1801679089
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Entity Type | Individual
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Provider Name | SUMAYA GEN OD
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Gender | Female
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 7305 W IRVING ROAD
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City | CHICAGO
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State | IL
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Zip | 60634
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Country | US
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Telephone | 773-589-1935
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Fax |
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Provider Business Mailing Address
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Address Line | 6141 N LINCOLN AVE
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City | CHICAGO
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State | IL
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Zip | 60659-2313
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Country | US
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Telephone | 773-596-5651
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046011748
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License Number State | IL
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