Basic Information
Provider Information
NPI: 1750802344
EntityType: 2
ReplacementNPI:  
OrganizationName: THE SNF GROUP, PLLC
LastName:  
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Mailing Information
Address1: 1S450 SUMMIT AVE STE 165
Address2:  
City: OAKBROOK TERRACE
State: IL
PostalCode: 601813952
CountryCode: US
TelephoneNumber: 6303206871
FaxNumber: 6303850026
Practice Location
Address1: 1815 BACK CREEK DR
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282132159
CountryCode: US
TelephoneNumber: 7084802650
FaxNumber: 7085752876
Other Information
ProviderEnumerationDate: 07/05/2017
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: ALMOSHELLI
AuthorizedOfficialFirstName: BADER
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AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 6304801117
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate: 08/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansFamily Medicine 
207R00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 
208D00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansGeneral Practice 
208100000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 

No ID Information.


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