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General NPI Number Information
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NPI Number | 1861279390
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Entity Type | Organization
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Legal Business Name | REHAB CHIRO ELIUD M SIERRA JR SOLE MBR
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Dates
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Enumeration Date | 09/08/2023
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Last Update Date | 12/01/2023
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Provider Practice Location Address
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Address Line | 148 S BLOOMINGDALE RD STE 107C
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1491
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Country | US
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Telephone | 630-877-7389
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Fax | 630-982-1278
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Provider Business Mailing Address
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Address Line | 345 SHAWNEE DR
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City | CAROL STREAM
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State | IL
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Zip | 60188-1966
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Country | US
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Telephone | 630-877-7389
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. ELIUD MIGUEL SIERRA JR.
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Credential | DC
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Telephone | 630-877-7389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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