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General NPI Number Information
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NPI Number | 1831689702
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Entity Type | Individual
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Provider Name | JEREMY VAN DO
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Gender | Male
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Dates
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Enumeration Date | 05/15/2018
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 2100 PFINGSTEN RD
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City | GLENVIEW
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State | IL
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Zip | 60026-1301
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Country | US
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Telephone | 847-657-4900
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Fax | 847-733-5041
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Provider Business Mailing Address
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Address Line | 2650 RIDGE AVE STE 1223
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City | EVANSTON
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State | IL
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Zip | 60201-1700
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Country | US
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Telephone |
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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 | 036.155845
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 036-155845
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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 | 125071891
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036155845
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License Number State | IL
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