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General NPI Number Information
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NPI Number | 1811949100
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Entity Type | Individual
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Provider Name | BETH WESTELL O.D.
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Gender | Female
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 909 W MAIN ST
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City | WEST FRANKFORT
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State | IL
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Zip | 62896-2209
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Country | US
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Telephone | 618-937-2442
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Fax | 618-932-2875
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Provider Business Mailing Address
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Address Line | 1200 W DEYOUNG ST
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City | MARION
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State | IL
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Zip | 62959-4437
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Country | US
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Telephone | 618-993-5686
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Fax | 618-997-6250
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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 | 046-008735
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License Number State | IL
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