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General NPI Number Information
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NPI Number | 1801886593
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Entity Type | Individual
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Provider Name | MUHANNAD KAYALI M.D
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Gender | Male
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 6920 OGDEN AVE
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City | BERWYN
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State | IL
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Zip | 60402-3685
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Country | US
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Telephone | 708-482-3118
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Fax | 708-482-3140
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Provider Business Mailing Address
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Address Line | 6920 OGDEN AVE
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City | BERWYN
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State | IL
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Zip | 60402-3685
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Country | US
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Telephone | 708-447-1700
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 64562
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036-094540
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 37720
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 37720
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License Number State | WI
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