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General NPI Number Information
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NPI Number | 1861450330
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Entity Type | Individual
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Provider Name | GERALD SIMON MD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 6438 JOLIET RD STE 203
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City | COUNTRYSIDE
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State | IL
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Zip | 60525-4624
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Country | US
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Telephone | 708-352-5222
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Fax | 708-352-1576
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Provider Business Mailing Address
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Address Line | 120 W 22ND ST STE 200
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City | OAK BROOK
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State | IL
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Zip | 60523-1563
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Country | US
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Telephone | 630-573-5000
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 36066840
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036066840
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License Number State | IL
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