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General NPI Number Information
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NPI Number | 1962945055
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Entity Type | Organization
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Legal Business Name | PRESENCE AMBULATORY SERVICES
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Dates
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Enumeration Date | 11/22/2016
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Last Update Date | 11/22/2016
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Provider Practice Location Address
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Address Line | 500 S WEBER RD
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City | ROMEOVILLE
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State | IL
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Zip | 60446-6528
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Country | US
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Telephone | 815-254-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 REMINGTON BLVD SUITE 100
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City | BOLINGBROOK
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State | IL
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Zip | 60440-5114
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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 | MANAGER REVENUE CYCLE OPERATIONS
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Name | JENNIFER SCAFIDI
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Credential |
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Telephone | 630-914-2468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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