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General NPI Number Information
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NPI Number | 1851817183
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Entity Type | Organization
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Legal Business Name | HCC OF ROCHELLE, LLC
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 08/18/2017
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Provider Practice Location Address
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Address Line | 900 N 2ND ST
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City | ROCHELLE
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State | IL
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Zip | 61068-1764
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Country | US
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Telephone | 815-562-2181
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 96348
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City | OKLAHOMA CITY
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State | OK
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Zip | 73143-6348
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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 | CEO
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Name | RON WEISS
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Credential |
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Telephone | 866-931-8882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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