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General NPI Number Information
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NPI Number | 1982016499
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Entity Type | Individual
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Provider Name | AMANDA LIPON M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 120 N OAK ST
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City | HINSDALE
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State | IL
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Zip | 60521-3829
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Country | US
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Telephone | 630-856-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 907 PRAIRIE AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-3638
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Country | US
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Telephone | 630-267-1538
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036143399
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License Number State | IL
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