ProviderBusinessMailingAddressFaxNumber = '7739730506'

NPI	LastName	FirstName	MidName	Organization	Mailing Address	City	State	Zip
1578799748	DA FONSECA	CARLOS	RAFAEL		2901 W TOUHY AVE	CHICAGO	IL	606452937
1518410794	HAGERTY	MARK			2901 W TOUHY AVE	CHICAGO	IL	606452937

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