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General NPI Number Information
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NPI Number | 1861957144
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Entity Type | Organization
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Legal Business Name | RSR MEDICAL
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Dates
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Enumeration Date | 01/31/2019
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Last Update Date | 01/31/2019
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Provider Practice Location Address
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Address Line | 1509 N WESTERN AVE UNIT 404
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City | CHICAGO
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State | IL
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Zip | 60622-1747
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Country | US
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Telephone | 708-691-3953
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Fax |
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Provider Business Mailing Address
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Address Line | 1509 N WESTERN AVE UNIT 404
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City | CHICAGO
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State | IL
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Zip | 60622-1747
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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 | PARTNER
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Name | RICHARD REZKO
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Credential | MD
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Telephone | 708-691-3953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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