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General NPI Number Information
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NPI Number | 1861242042
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Entity Type | Organization
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Legal Business Name | MEDICAID SUPPORT, LLC
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Dates
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Enumeration Date | 03/22/2024
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 21660 W FIELD PKWY
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City | DEER PARK
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State | IL
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Zip | 60010-7265
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Country | US
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Telephone | 847-512-3579
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Fax | 866-578-1828
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Provider Business Mailing Address
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Address Line | PO BOX 517
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City | BARRINGTON
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State | IL
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Zip | 60011-0517
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Country | US
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Telephone | 877-512-3579
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Fax | 866-578-1828
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Authorized Official
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Title or Position | CEO
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Name | YISRAELA YEHUDAH
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Credential |
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Telephone | 847-512-3579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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