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General NPI Number Information
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NPI Number | 1861588352
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Entity Type | Individual
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Provider Name | MASON WAYNE MILBURN M.D
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 1500 S FAIRFIELD AVE
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City | CHICAGO
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State | IL
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Zip | 60608
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Country | US
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Telephone | 773-257-6663
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Fax |
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Provider Business Mailing Address
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Address Line | 909 S MADISON ST
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City | HINSDALE
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State | IL
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Zip | 60521-4370
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Country | US
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Telephone | 414-232-8034
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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 | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | 036125204
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 036125204
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License Number State | IL
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