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General NPI Number Information
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NPI Number | 1912248741
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE FAMILY HEALTHCARE
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 3626 E STATE ST
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City | ROCKFORD
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State | IL
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Zip | 61108-1916
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Country | US
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Telephone | 779-423-1700
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Fax | 866-596-1027
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Provider Business Mailing Address
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Address Line | 3626 E STATE ST
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City | ROCKFORD
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State | IL
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Zip | 61108-1916
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Country | US
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Telephone | 779-423-1700
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Fax | 866-596-1027
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Authorized Official
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Title or Position | OWNER
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Name | DR. COLLEEN NOE
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Credential | D.C.
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Telephone | 779-423-1700
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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 | 038.012245
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License Number State | IL
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