INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('462252776', 'W12049760', 'W12049760', 'UT01', 'Premier Family Medical', 'Russell', 'S', 'Anderson', 'DO', 'Family Practice', '', '', NULL, 'O', '680 E Main St', 'Lehi', 'Utah', 'UT', '84043', '8017681699', '8017561705', '680 E Main St', 'Lehi', 'Utah', 'UT', '84043', '8017681699', '8017561705', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-04-22', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1548407513', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('462252776', 'W12049761', 'W12049761', 'UT01', 'Premier Family Medical', 'Russell', 'S', 'Anderson', 'DO', 'Family Practice', '', '', NULL, 'O', '76 E Commerce Dr Ste 204', 'Saratoga Springs', 'Utah', 'UT', '84045', '8017668427', '8017561705', '76 E Commerce Dr Ste 204', 'Saratoga Springs', 'Utah', 'UT', '84045', '8017668427', '8017561705', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-04-22', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1548407513', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('462252776', 'W12049757', 'W12049757', 'UT01', 'Premier Family Medical', 'Russell', 'S', 'Anderson', 'DO', 'Family Practice', '', '', NULL, 'O', '830 N 2000 W', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017563511', '          ', '830 N 2000 W', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017563511', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-04-22', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1548407513', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('200582039', 'W12049762', 'W12049762', 'UT01', 'Sundance Physical Therapy', 'Sherri', '', 'Duft', 'PT', 'Physical Therapy', '', '', NULL, 'O', '3870 Stadium Way Dept 2701', 'Ogden', 'Weber', 'UT', '84408', '8016267712', '8016267264', '3870 Stadium Way Dept 2701', 'Ogden', 'Weber', 'UT', '84408', '8016267712', '8016267264', 'WESTREHAB', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-07-10', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1780676569', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('200582039', 'W12049763', 'W12049763', 'UT01', 'Sundance Physical Therapy', 'Clay', '', 'Sniteman', 'PT', 'Physical Therapy', '', '', NULL, 'O', '3870 Stadium Way Dept 2701', 'Ogden', 'Weber', 'UT', '84408', '8016267712', '8016267264', '3870 Stadium Way Dept 2701', 'Ogden', 'Weber', 'UT', '84408', '8016267712', '8016267264', 'WESTREHAB', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-07-10', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1235295049', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('870543675', 'W12049764', 'W12049764', 'UT01', 'Orem Sports Medicine Center ', 'Matthew', 'Frampton', 'Bushnell', 'DPT', 'Physical Therapy', '', '', NULL, 'B', '524 W 300 N Ste 201', 'Provo', 'Utah', 'UT', '84601', '8012260599', '8012263145', '524 W 300 N Ste 201', 'Provo', 'Utah', 'UT', '84601', '8012260599', '8012263145', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-07-10', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1033402607', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('202906249', 'W12049766', 'W12049766', 'UT01', 'Advanced Motion Physical Therapy', 'Cory', 'J', 'Freeman', 'DPT', 'Physical Therapy', '', '', NULL, 'O', '3665 S 8400 W Ste 210', 'Magna', 'Salt Lake', 'UT', '84044', '8012506733', '8012505038', '3665 S 8400 W Ste 210', 'Magna', 'Salt Lake', 'UT', '84044', '8012506733', '8012505038', 'WESTREHAB', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1548554504', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('262792136', 'W12049768', 'W12049768', 'ID02', 'Advanced Therapy Care', 'Maureen', 'L', 'Wray', 'SLP', 'Speech Therapy', '', '', NULL, 'O', '245 N 3rd E', 'Mountain Home', 'Elmore', 'ID', '83647', '2085878255', '2085874475', '245 N 3rd E', 'Mountain Home', 'Elmore', 'ID', '83647', '2085878255', '2085874475', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-04-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA', '1659608248', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('262792136', 'W12049770', 'W12049770', 'ID02', 'Advanced Therapy Care', 'Jamie', 'A', 'Weishaar', 'PT', 'Physical Therapy', '', '', NULL, 'O', '68 S Baltic Pl', 'Meridian', 'Ada', 'ID', '83642', '2088980988', '2088989022', '68 S Baltic Pl', 'Meridian', 'Ada', 'ID', '83642', '2088980988', '2088989022', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-04-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA', '1871632646', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('464979894', 'W12049771', 'W12049771', 'UT01', 'Mountain View Physical Therapy & Rehabilitation', 'James', '', 'Harrison', 'PT', 'Physical Therapy', '', '', NULL, 'O', '6770 S 900 E Ste 205', 'Midvale', 'Salt Lake', 'UT', '84047', '8019963626', '8015238242', '6770 S 900 E Ste 205', 'Midvale', 'Salt Lake', 'UT', '84047', '8019963626', '8015238242', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-08-01', NULL, 0, 0, 0, '', '', '', '', '', '1558459321', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('820489551', 'W12049773', 'W12049773', 'ID02', 'Teton Physical Therapy', 'Russell', 'G', 'Griffeth', 'MPT', 'Physical Therapy', '', '', NULL, 'O', '2037 E 17th St', 'Meridian', 'Ada', 'ID', '83642', '2085293355', '2085299581', '2037 E 17th St', 'Meridian', 'Ada', 'ID', '83642', '2085293355', '2085299581', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1841359866', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('820506675', 'W12049774', 'W12049774', 'ID02', 'Physical Therapy of Idaho', 'Brian', 'J', 'Murphy', 'PT', 'Physical Therapy', '', '', NULL, 'O', '3090 E Gentry Way Ste 250', 'Meridian', 'Ada', 'ID', '83642', '2088880044', '2088882211', '3090 E Gentry Way Ste 250', 'Meridian', 'Ada', 'ID', '83642', '2088880044', '2088882211', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-06-18', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1740335215', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('200685860', 'W12049775', 'W12049775', 'ID02', 'Physical Therapy of Idaho', 'Brian', 'J', 'Murphy', 'PT', 'Physical Therapy', '', '', NULL, 'O', '8854 W Emerald St Ste 280', 'Boise', 'Ada', 'ID', '83704', '2083775005', '2083778484', '8854 W Emerald St Ste 280', 'Boise', 'Ada', 'ID', '83704', '2083775005', '2083778484', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-06-18', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1740335215', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('463105812', 'W12049777', 'W12049777', 'ID02', 'Orofino Physical Therapy and Wellness', 'Joshua', 'O', 'Tilley', 'DPT', 'Physical Therapy', '', '', NULL, 'O', '1005 Michigan Ave', 'Orofino', 'Clearwater', 'ID', '83544', '2084769365', '2084769366', '1005 Michigan Ave', 'Orofino', 'Clearwater', 'ID', '83544', '2084769365', '2084769366', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164850947', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('463105812', 'W12049778', 'W12049778', 'ID02', 'Orofino Physical Therapy and Wellness', 'Joshua', 'O', 'Tilley', 'DPT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 2546', 'Orofino', 'Clearwater', 'ID', '83544', '2084769365', '2084769366', 'PO Box 2546', 'Orofino', 'Clearwater', 'ID', '83544', '2084769365', '2084769366', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164850947', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('820520880', 'W12049780', 'W12049780', 'ID02', 'Peak Physical Therapy, PC', 'Charles', 'H', 'Sands', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1005 6th S', 'Mountain Home', 'Elmore', 'ID', '83647', '2085871777', '2085871784', '1005 6th S', 'Mountain Home', 'Elmore', 'ID', '83647', '2085871777', '2085871784', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-04-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1821034513', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('820520880', 'W12049781', 'W12049781', 'ID02', 'Peak Physical Therapy, PC', 'Charles', 'H', 'Sands', 'PT', 'Physical Therapy', '', '', NULL, 'O', '7550 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2085856566', '2085856768', '7550 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2085856566', '2085856768', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-04-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1821034513', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('820520880', 'W12049783', 'W12049783', 'ID02', 'Peak Physical Therapy, PC', 'Joshua', 'A', 'Mason', 'DPT', 'Physical Therapy', '', '', NULL, 'O', '7550 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2085856566', '2085856768', '7550 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2085856566', '2085856768', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-04-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1467786285', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('820520880', 'W12049784', 'W12049784', 'ID02', 'Peak Physical Therapy, PC', 'Joshua', 'A', 'Mason', 'DPT', 'Physical Therapy', '', '', NULL, 'O', '809 S Washington Ave', 'Emmett', 'Gem', 'ID', '83617', '2083655341', '2083655342', '809 S Washington Ave', 'Emmett', 'Gem', 'ID', '83617', '2083655341', '2083655342', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-04-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1467786285', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('470955118', 'W12049786', 'W12049786', 'ID02', 'Rebound Physical Therapy, PC', 'Anthony', 'T', 'Peppley', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1175 E Parkcenter Blvd Ste 104', 'Boise', 'Ada', 'ID', '83706', '2083442525', '2083443056', '1175 E Parkcenter Blvd Ste 104', 'Boise', 'Ada', 'ID', '83706', '2083442525', '2083443056', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144335860', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('263885378', 'W12049788', 'W12049788', 'ID02', 'SPA Communtications', 'Kriste', '', 'Barnes-Perrin', 'SLP', 'Speech Therapy', '', '', NULL, 'O', '23 E 1st St N', 'Middleton', 'Canyon', 'ID', '83644', '2086310585', '2085856678', '23 E 1st St N', 'Middleton', 'Canyon', 'ID', '83644', '2086310585', '2085856678', 'WestRehab', '', '', '0.00', '0.00', '73.00', 3, '2014-04-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1487077046', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('262792136', 'W12049789', 'W12049789', 'ID02', 'Advanced Therapy Care', 'Taunya', '', 'Bos', 'SLP', 'Speech Therapy', '', '', NULL, 'O', '68 S Baltic Pl', 'Meridian', 'Ada', 'ID', '83642', '2088980988', '2088989022', '68 S Baltic Pl', 'Meridian', 'Ada', 'ID', '83642', '2088980988', '2088989022', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-04-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA', '1487929766', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('752338371', 'W12049791', 'W12049791', 'TXDALSTD', 'Southlake Oncology', 'Lee', '', 'Drinkard', 'MD', 'Hematology', '', '', NULL, 'O', '1545 E Southlake Blvd Ste 280', 'Southlake', 'Tarrant', 'TX', '76092', '8174160202', '9728693875', '1545 E Southlake Blvd Ste 280', 'Southlake', 'Tarrant', 'TX', '76092', '8174160202', '9728693875', 'BQA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-08-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487757084', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('752338371', 'W12049790', 'W12049790', 'TXDALSTD', 'Southlake Oncology', 'Lee', '', 'Drinkard', 'MD', 'Hematology', '', '', NULL, 'B', 'PO Box 674004', 'Dallas', 'Dallas', 'TX', '75267', '5852141600', '          ', 'PO Box 674004', 'Dallas', 'Dallas', 'TX', '75267', '5852141600', '          ', 'BQA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-08-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487757084', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('760540476', 'W12049792', 'W12049792', 'TXHOUSTD', 'Oakbend Medical Group', 'Gildardo', '', 'Ceballos', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4911 Sand Hill Dr', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812387870', '2816334985', '4911 Sand Hill Dr', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2812387870', '2816334985', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-08-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1689956906', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('742915297', 'W12049793', 'W12049793', 'TXSATSTD', 'South Texas Oncology and Hematology', 'Kathy', 'D', 'Grove', 'MD', 'General Surgery', '', '', NULL, 'O', '2632 Broadway St Ste 102 North', 'San Antonio', 'Bexar', 'TX', '78215', '2102241971', '2102245084', '2632 Broadway St Ste 102 North', 'San Antonio', 'Bexar', 'TX', '78215', '2102241971', '2102245084', 'TXONCOL', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2014-08-01', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1710912860', 0, 'N', 0, '2014-07-25', NULL, NULL, 0, 0, NULL, NULL),
('742915297', 'W12049794', 'W12049794', 'TXSATSTD', 'South Texas Oncology and Hematology', 'Kathy', 'D', 'Grove', 'MD', 'General Surgery', '', '', NULL, 'O', '7579 N Loop 1604 W Ste 200', 'San Antonio', 'Bexar', 'TX', '78249', '2102241971', '2102245084', '7579 N Loop 1604 W Ste 200', 'San Antonio', 'Bexar', 'TX', '78249', '2102241971', '2102245084', 'TXONCOL', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2014-08-01', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1710912860', 0, 'N', 0, '2014-07-25', NULL, NULL, 0, 0, NULL, NULL),
('742915297', 'W12049795', 'W12049795', 'TXSATSTD', 'South Texas Oncology and Hematology', 'Kathy', 'D', 'Grove', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 268', 'San Antonio', 'Bexar', 'TX', '78291', '2102241971', '2102245084', 'PO Box 268', 'San Antonio', 'Bexar', 'TX', '78291', '2102241971', '2102245084', 'TXONCOL', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2014-08-01', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1710912860', 0, 'N', 0, '2014-07-25', NULL, NULL, 0, 0, NULL, NULL),
('741849254', 'W12049796', 'W12049796', 'TXSATSTD', 'Southeast Surgical Associates', '', '', 'Southeast Surgical Associates', 'GROUP', 'General Surgery', '', '', NULL, 'O', '8019 S New Braunfels Ste 115', 'San Antonio', 'Bexar', 'TX', '78235', '2103337510', '2103331912', '8019 S New Braunfels Ste 115', 'San Antonio', 'Bexar', 'TX', '78235', '2103337510', '2103331912', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2014-07-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008843', 0, 'N', 1, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('741849254', 'W12049797', 'W12049797', 'TXSATSTD', 'Southeast Surgical Associates', 'Morris', 'E', 'Franklin', 'MD', 'General Surgery', '', '', NULL, 'O', '8019 S New Braunfels Ste 115', 'San Antonio', 'Bexar', 'TX', '78235', '2103337510', '2103331912', '8019 S New Braunfels Ste 115', 'San Antonio', 'Bexar', 'TX', '78235', '2103337510', '2103331912', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2014-07-15', NULL, 0, 0, 0, 'North Central Baptist Hospital', '', '', '', 'HCFA|UB|', '1932104791', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('741849254', 'W12049798', 'W12049798', 'TXSATSTD', 'Southeast Surgical Associates', 'Jeffrey', 'L', 'Glass', 'MD', 'General Surgery', '', '', NULL, 'O', '8019 S New Braunfels Ste 115', 'San Antonio', 'Bexar', 'TX', '78235', '2103337510', '2103331912', '8019 S New Braunfels Ste 115', 'San Antonio', 'Bexar', 'TX', '78235', '2103337510', '2103331912', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2014-07-15', NULL, 0, 0, 0, 'Baptist Medical Center', 'North Central Baptist Hospital', '', '', 'HCFA|UB|', '1487615720', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'W12049800', 'W12049800', 'NM01', 'ABQ Health Partners ', 'Zachary', '', 'Stengel', 'MD', 'Family Practice', '', '', NULL, 'O', '200 Rio Bravo Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736400', '5058736403', '200 Rio Bravo Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736400', '5058736403', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2014-07-14', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669549127', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'W12049801', 'W12049801', 'NM01', 'ABQ Health Partners', 'Zachary', '', 'Stengel', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2014-07-14', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669549127', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'W12049802', 'W12049802', 'NM01', 'ABQ Health Partners', 'Zachary', '', 'Stengel', 'MD', 'Family Practice', '', '', NULL, 'O', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2014-07-14', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669549127', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'W12049803', 'W12049803', 'NM01', 'ABQ Health Partners', 'Peter', '', 'Wong', 'MD', 'Family Practice', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623233', '5052623191', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623233', '5052623191', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2014-07-16', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427071521', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('271957809', 'W12049804', 'W12049804', 'UTDT01', 'Stansbury Pediatric Dentistry', 'Daniel', '', 'Linford', '', 'Dentist', '', '', NULL, 'O', '220 Millpond Dr Ste 107', 'Tooele', 'Tooele', 'UT', '84074', '4358435437', '          ', '220 Millpond Dr Ste 107', 'Tooele', 'Tooele', 'UT', '84074', '4358435437', '          ', 'UT000A', '', '', '0.00', '20.00', '0.00', 8, '2014-07-01', NULL, 0, 0, 0, '', '', '', '', 'DEN|', '1013228709', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('454046913', 'W12049805', 'W12049805', 'UTDT01', 'Oquirrh Hills Dental Care', 'Travis', '', 'Perkins', 'DMD', 'Dentist', '', '', NULL, 'O', '1204 N Main St', 'Tooele', 'Tooele', 'UT', '84074', '4355794600', '          ', '1204 N Main St', 'Tooele', 'Tooele', 'UT', '84074', '4355794600', '          ', 'UT000A', '', '', '0.00', '20.00', '0.00', 8, '2014-07-01', NULL, 0, 0, 0, '', '', '', '', 'DEN|', '1982840203', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('263716255', 'W12049806', 'W12049806', 'UTDT01', 'Lakeview Dental Syracuse', 'Travis', '', 'Perkins', 'DMD', 'Dentist', '', '', NULL, 'O', '1662 S 2000 W Ste A1', 'Syracuse', 'Davis', 'UT', '84075', '8018252273', '          ', '1662 S 2000 W Ste A1', 'Syracuse', 'Davis', 'UT', '84075', '8018252273', '          ', 'UT000A', '', '', '0.00', '20.00', '0.00', 8, '2014-07-01', NULL, 0, 0, 0, '', '', '', '', 'DEN|', '1982840203', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('465563185', 'W12049807', 'W12049807', 'UTDT01', 'Michael A Blamires DDS, Inc', 'Michael', '', 'Blamires', 'DDS', 'Dentist', '', '', NULL, 'O', '5974 S Fashion Pointe Dr Ste 230', 'Ogden', 'Weber', 'UT', '84403', '8016218440', '          ', '5974 S Fashion Pointe Dr Ste 230', 'Ogden', 'Weber', 'UT', '84403', '8016218440', '          ', 'UT000A', '', '', '0.00', '20.00', '0.00', 8, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'DEN|', '1912068750', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('272177703', 'W12049809', 'W12049809', 'UTDT01', 'Canyon Dental', 'R Joseph', '', 'Magness', 'DDS', 'Dentist', '', '', NULL, 'O', '528 E 800 N', 'Orem', 'Utah', 'UT', '84097', '8012246051', '          ', '528 E 800 N', 'Orem', 'Utah', 'UT', '84097', '8012246051', '          ', 'UT000A', '', '', '0.00', '20.00', '0.00', 8, '2014-06-01', NULL, 0, 0, 0, '', '', '', '', 'DEN|', '1720248586', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('870660175', 'W12049808', 'W12049808', 'UTDT01', 'Cache Valley Smiles', 'Matthew', '', 'Cheney', 'DMD', 'Dentist', '', '', NULL, 'O', '167 S 200 E Ste 3', 'Logan', 'Cache', 'UT', '84321', '4357523689', '          ', '167 S 200 E Ste 3', 'Logan', 'Cache', 'UT', '84321', '4357523689', '          ', 'UT000A', '', '', '0.00', '20.00', '8.00', 8, '2014-06-01', NULL, 0, 0, 0, '', '', '', '', '|DEN|', '1942398268', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('465607810', 'W12049810', 'W12049810', 'UTDT01', 'Utah Facial and Oral Surgery', 'Christopher', '', 'Price', 'DDS MD', 'Oral Surgeon', '', '', NULL, 'O', '3473 W S Jordan Pkwy Ste 4', 'South Jordan', 'Salt Lake', 'UT', '84095', '8014464428', '          ', '3473 W S Jordan Pkwy Ste 4', 'South Jordan', 'Salt Lake', 'UT', '84095', '8014464428', '          ', 'UT0SPA', '', '', '0.00', '100.00', '0.00', 8, '2014-06-01', NULL, 0, 0, 0, '', '', '', '', 'DEN|', '1508069105', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('452916460', 'W12049812', 'W12049812', 'UTDT01', 'Horizon Dental', 'Allen', '', 'Vernon', 'DMD', 'Dentist', '', '', NULL, 'O', '3915 Ogden Ave', 'Ogden', 'Weber', 'UT', '84403', '8013921000', '          ', '3915 Ogden Ave', 'Ogden', 'Weber', 'UT', '84403', '8013921000', '          ', 'UT000A', '', '', '0.00', '20.00', '0.00', 8, '2014-06-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619297843', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('900120192', 'W12049813', 'W12049813', 'TXSATSTD', 'Center for Physical Therapy and Sports Performance', '', '', 'Sports Medicine Associates of San Antonio', '', 'Orthopedic Surgery', 'Physical Therapy', '', NULL, 'O', '5917 Broadway', 'San Antonio', 'Bexar', 'TX', '78209', '2102533451', '2108235429', '5917 Broadway', 'San Antonio', 'Bexar', 'TX', '78209', '2102533451', '2108235429', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2014-07-18', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1861549503', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('342058017', 'SANANT001', 'SANANT001', 'TXSATSTD', 'Aaron Mason Md Pa', 'Aaron', '', 'Mason', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '343 Houston St Ste 206', 'San Antonio', 'Bexar', 'TX', '78205', '', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130058', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT002', 'SANANT002', 'TXSATSTD', 'Abdu A Kadri Md', 'Abdu', '', 'Kadri', 'MD', 'Geriatrics', '', NULL, NULL, 'O', '3338 Oakwell Ct Ste 104', 'San Antonio', 'Bexar', 'TX', '78218', '2109466466', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Metroplitan Methodist Hospital', NULL, 'HCFA|UB|', '0000130059', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT003', 'SANANT003', 'TXSATSTD', 'Abel Cavazos Otr', 'Abel', '', 'Cavazos', 'OTR', 'Occupational Medicine', '', NULL, NULL, 'O', '21 Spurs Ln Ste 310', 'San Antonio', 'Bexar', 'TX', '78240', '2105587025', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130060', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742939989', 'SANANT004', 'SANANT004', 'TXSATSTD', 'Accent Plastic Surgery Pa', 'Sheryl', '', 'Pilcher', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '255 E Sonterra Blvd Ste 201', 'San Antonio', 'Bexar', 'TX', '78258', '2106549900', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'North Central Baptist Hospital', 'Northeast Methodist Hospital', NULL, 'HCFA|UB|', '0000130061', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742866672', 'SANANT005', 'SANANT005', 'TXSATSTD', 'Advanced Concpets In Plastic Surgery Pa', 'Suresh', '', 'Koneru', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '423 Treeline Park Ste 300', 'San Antonio', 'Bexar', 'TX', '78209', '2104995900', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130062', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('134319824', 'SANANT006', 'SANANT006', 'TXSATSTD', 'Alamo Cardiothoracic Surgical Associates Pa', '', '', 'Alamo Cardiothoracic Surgical Associates Pa', '', 'Thoracic Surgery', '', NULL, NULL, 'O', '14615 San Pedro Ste 218', 'San Antonio', 'Bexar', 'TX', '78232', '2104954200', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130063', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT007', 'SANANT007', 'TXSATSTD', 'Alfredo Villarreal-Rios Md', 'Alfredo', '', 'Villarreal Rios', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '8038 Wurzbach Rd Ste 211', 'san Antonio', 'Bexar', 'TX', '78229', '2106141211', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Houston Methodist Hospital', NULL, 'HCFA|UB|', '0000130064', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT008', 'SANANT008', 'TXSATSTD', 'Alpha Alpha Medical Pllc', '', '', 'Alpha Alpha Medical Pllc', '', 'Geriatrics', '', NULL, NULL, 'O', '7042 Bandera', 'San Antonio', 'Bexar', 'TX', '78238', '2105216886', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130065', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT009', 'SANANT009', 'TXSATSTD', 'Ather A Siddiqi Md', 'Ather', '', 'Siddiqi', 'MD', 'Radiation Oncology', '', NULL, NULL, 'O', '4411 Medical Dr Ste 100', 'San Antonio', 'Bexar', 'TX', '78229', '2105955300', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Christus Santa Rosa Medical Center', NULL, 'HCFA|UB|', '0000130066', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT010', 'SANANT010', 'TXSATSTD', 'Bradley R Prestidge Md', 'Bradley', '', 'Prestidge', 'MD', 'Radiation Oncology', '', NULL, NULL, 'O', '9102 Floyd Curl Dr', 'San Antonio', 'Bexar', 'TX', '78240', '2102470888', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Bon Secours Depaul Med Center', NULL, 'HCFA|UB|', '0000130067', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT011', 'SANANT011', 'TXSATSTD', 'Brant Rhodes Otr', 'Brant', '', 'Rhodes', 'OTR', 'Occupational Medicine', '', NULL, NULL, 'O', '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2103965300', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130068', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT012', 'SANANT012', 'TXSATSTD', 'Brittney Horecka Aud', 'Brittney', '', 'Horecka', 'AUD', 'Audiology', '', NULL, NULL, 'O', '21 Spurs Ln Ste 100', 'San Antonio', 'Bexar', 'TX', '78240', '2106146070', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130069', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742450942', 'SANANT013', 'SANANT013', 'TXSATSTD', 'Bruce Wood', 'Bruce', '', 'Wood', 'MD', 'Infectious Disease', '', NULL, NULL, 'O', '8000 Village Dr Ste 201', 'San Antonio', 'Bexar', 'TX', '78217', '8306277020', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130070', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742782325', 'SANANT014', 'SANANT014', 'TXSATSTD', 'Cancer Care Centers Of South Texas', 'Bryan', '', 'Lin', 'MD', 'Radiation Oncology', '', NULL, NULL, 'O', '1010 NW Loop Ste 410', 'San Antonio', 'Bexar', 'TX', '78213', '8324142001', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Christus Santa Rosa Medical Center', NULL, 'HCFA|UB|', '0000130071', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742782325', 'SANANT015', 'SANANT015', 'TXSATSTD', 'Cancer Care Centers Of South Texas', 'Michael', '', 'Gagnon', 'MD', 'Radiation Oncology', '', NULL, NULL, 'O', '4411 Medical Dr Ste 100', 'San Antonio', 'Bexar', 'TX', '78229', '2105955300', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Methodist Hospital', NULL, 'HCFA|UB|', '0000130072', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT016', 'SANANT016', 'TXSATSTD', 'Cardiothoracic Surgical Associates', '', '', 'Cardiothoracic Surgical Associates', '', 'Thoracic Surgery', '', NULL, NULL, 'O', '6800 IH 10 West Ste 300', 'San Anonio', 'Bexar', 'TX', '78201', '2106160008', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130073', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT017', 'SANANT017', 'TXSATSTD', 'Cecilia A Mitchell Md', 'Cecilia', '', 'Mitchell', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '4499 Medical Dr Ste SL1', 'san Antonio', 'Bexar', 'TX', '78229', '2106158757', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'North Central Baptist Hospital', 'St Lukes Baptist Hospital', NULL, 'HCFA|UB|', '0000130074', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT018', 'SANANT018', 'TXSATSTD', 'Christina A Mccune Md', 'Christina', '', 'Mccune', 'MD', 'Diagnostic Radiology', '', NULL, NULL, 'O', '520 Madison Oak Dr', 'San Antonio', 'Bexar', 'TX', '78258', '2105586288', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130075', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT019', 'SANANT019', 'TXSATSTD', 'Christine L Gear Md', 'Christine', '', 'Gear', 'MD', 'Hospitalist', '', NULL, NULL, 'O', '7940 Floyd Curl Dr Ste 260', 'San Antonio', 'Bexar', 'TX', '78229', '2106147900', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'University Health System', NULL, 'HCFA|UB|', '0000130076', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT020', 'SANANT020', 'TXSATSTD', 'Clear Hearing Llc', 'Cynthia', '', 'Wright', 'AUD', 'Audiology', '', NULL, NULL, 'O', '6067 DeZavala Rd', 'San Antonio', 'Bexar', 'TX', '78249', '2105587858', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130077', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT021', 'SANANT021', 'TXSATSTD', 'Colleen Kennedy', 'Colleen', '', 'Kennedy', 'MD', 'Geriatrics', '', NULL, NULL, 'O', '6401 El Verde', 'San Antonio', 'Bexar', 'TX', '78238', '2106412033', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130078', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT022', 'SANANT022', 'TXSATSTD', 'Colorectal Surgery Srvices Pllc', 'John', '', 'Winston', 'MD', 'Colon and Rectal Surgery', '', NULL, NULL, 'O', '19288 Stone Oak Pkwy', 'San Antonio', 'Bexar', 'TX', '78258', '2104902828', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', '', NULL, 'HCFA|UB|', '0000130079', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT023', 'SANANT023', 'TXSATSTD', 'Concord Imaging Of San Antonio', '', '', 'Concord Imaging Of San Antonio', '', 'Diagnostic Radiology', '', NULL, NULL, 'O', '18802 Meisner Dr', 'San Antonio', 'Bexar', 'TX', '78258', '', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130080', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT024', 'SANANT024', 'TXSATSTD', 'Cynthia D Alexander Otr', 'Cynthia', '', 'Alexander', 'OTR', 'Occupational Medicine', '', NULL, NULL, 'O', '8550 Datapoint Dr Ste 110', 'San Antonio', 'Bexar', 'TX', '78229', '2106155350', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130081', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT025', 'SANANT025', 'TXSATSTD', 'Daniel Pacheco Md', 'Daniel', '', 'Pacheco', 'MD', 'Diagnostic Radiology', '', NULL, NULL, 'O', '8811 Village Dr', 'San Antonio', 'Bexar', 'TX', '78217', '2104550167', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130082', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT026', 'SANANT026', 'TXSATSTD', 'David A Ives Aud', 'David', '', 'Ives', 'AUD', 'Audiology', '', NULL, NULL, 'O', '8706 McCullough Ave Ste D9', 'San Antonio', 'Bexar', 'TX', '78216', '2103496000', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130083', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT027', 'SANANT027', 'TXSATSTD', 'David N Novick Md', 'David', '', 'Novick', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '7950 Floyd Curl Dr Ste 904', 'san Antonio', 'Bexar', 'TX', '78229', '2106160798', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'St Lukes Baptist Hospital', 'Methodist Childrens Hospital SW TX', NULL, 'HCFA|UB|', '0000130084', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT028', 'SANANT028', 'TXSATSTD', 'David S Levey Md', 'David', '', 'Levey', 'MD', 'Diagnostic Radiology', '', NULL, NULL, 'O', '622 Cinnamon Oak', 'Shavano Park', 'Bexar', 'TX', '78230', '2104920050', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130085', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT029', 'SANANT029', 'TXSATSTD', 'David W Person Md', 'David', '', 'Person', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '21 Spurs Ln Ste 310', 'san Antonio', 'Bexar', 'TX', '78240', '2105587025', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'North Central Baptist Hospital', NULL, 'HCFA|UB|', '0000130086', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT030', 'SANANT030', 'TXSATSTD', 'Devang N Patel Md', 'Devang', '', 'Patel', 'MD', 'Cardiology', '', NULL, NULL, 'O', '4411 Medical Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78229', '2106145400', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'North Central Baptist Hospital', NULL, 'HCFA|UB|', '0000130087', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742146518', 'SANANT031', 'SANANT031', 'TXSATSTD', 'Diabetes And Glandular Disease Clinic Pa', '', '', 'Diabetes And Glandular Disease Clinic Pa', '', 'Endocrinology', '', NULL, NULL, 'O', '5107 Medical Dr', 'San Antonio', 'Bexar', 'TX', '78229', '2106148612', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130088', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT032', 'SANANT032', 'TXSATSTD', 'Diabetes And Metabolism Specialists', '', '', 'Diabetes And Metabolism Specialists', '', 'Endocrinology', '', NULL, NULL, 'O', '5250 Oak Centre Ste 320', 'San Antonio', 'Bexar', 'TX', '78258', '2104943739', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130089', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT033', 'SANANT033', 'TXSATSTD', 'Doss Audiology And Hearing Center Pllc', 'Phallon', '', 'Doss', 'AUD', 'Audiology', '', NULL, NULL, 'O', '5000hertz Pkwy Ste 30', 'Schertz', 'Oklahoma', 'TX', '73154', '2108195002', '          ', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130090', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT034', 'SANANT034', 'TXSATSTD', 'Ear Institute Of Texas P A', 'Amberly', '', 'Nye', 'AUD', 'Audiology', '', NULL, NULL, 'O', '18518 Hardy Oak Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2106964327', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130091', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT035', 'SANANT035', 'TXSATSTD', 'Ear Institute Of Texas P A', 'Tarun', '', 'Wadhwa', 'AUD', 'Audiology', '', NULL, NULL, 'O', '18518 Hardy Oak Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2106964327', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130092', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT036', 'SANANT036', 'TXSATSTD', 'Ear Institute Of Texas P A', 'Lance', '', 'Jackson', 'MD', 'Neurotology', '', NULL, NULL, 'O', '18518 Hardy Oak Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2106964327', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130093', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT037', 'SANANT037', 'TXSATSTD', 'Ear Institute Of Texas P A', 'Walter', '', 'Bain', 'MD', 'Ear, Nose and Throat', '', NULL, NULL, 'O', '18518 Hardy Oak Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2106964327', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130094', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742283401', 'SANANT038', 'SANANT038', 'TXSATSTD', 'Ear Medical Group Pa', 'Charles', '', 'Symms Iii', 'MD', 'Neurotology', '', NULL, NULL, 'O', '21 Spurs Ln Ste 100', 'San Antonio', 'Bexar', 'TX', '78240', '2106146020', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130095', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT039', 'SANANT039', 'TXSATSTD', 'Eddie A Garcia Md', 'Eddie', '', 'Garcia', 'MD', 'Sports Medicine', '', NULL, NULL, 'O', '325 E Sonterra Blvd Ste 120', 'San Antonio', 'Bexar', 'TX', '78258', '2106145100', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'St Lukes Baptist Hospital', NULL, 'HCFA|UB|', '0000130096', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742504910', 'SANANT040', 'SANANT040', 'TXSATSTD', 'Elizabeth Harris', 'Elizabeth', '', 'Harris', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '540 Madison Oak Dr Ste 400', 'San Antonio', 'Bexar', 'TX', '78258', '2105454848', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130097', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742430251', 'SANANT041', 'SANANT041', 'TXSATSTD', 'Enrique C Almaguer Md Pa', 'Enrique', '', 'Almaguer', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '8038 Wurzbach Rd Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '          ', '          ', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Nix Health Care System', '', 'HCFA|UB|', '0000130098', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742981332', 'SANANT042', 'SANANT042', 'TXSATSTD', 'Eric Schaffer', 'Eric', '', 'Schaffer', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '1303 McCullough Ave Ste 363', 'San Antonio', 'Bexar', 'TX', '78212', '2102273223', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130099', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT043', 'SANANT043', 'TXSATSTD', 'Estes Audiology Pa', 'Soriya', '', 'Estes', 'AUD', 'Audiology', '', NULL, NULL, 'O', '1528 Common St Ste 5', 'New Braunsfel', 'Comal', 'TX', '78130', '8306430033', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130100', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('201621491', 'SANANT044', 'SANANT044', 'TXSATSTD', 'Francisco B Rodriguez Iv Md Pa Et Al Ptr', '', '', 'Francisco B Rodriguez Iv Md Pa Et Al Ptr', '', 'Thoracic Surgery', '', NULL, NULL, 'O', '1200 Brooklyn Ave Ste 210', 'San Antonio', 'Bexar', 'TX', '78212', '2102020222', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130101', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT045', 'SANANT045', 'TXSATSTD', 'Freddy Angulo Md', 'Freddy', '', 'Angulo', 'MD', 'Hospitalist', '', NULL, NULL, 'O', '600 N Union Ave', 'New Braunfels', 'Comal', 'TX', '78130', '8306435118', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Christus Santa Rosa Hospital- New Braunfels', 'Baptist Medical Center', NULL, 'HCFA|UB|', '0000130102', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT046', 'SANANT046', 'TXSATSTD', 'Gary Arishita Md', 'Gary', '', 'Arishita', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '9635 Huebner Rd', 'san Antonio', 'Bexar', 'TX', '78240', '2106921181', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'St Lukes Baptist Hospital', 'Methodist Hospital', NULL, 'HCFA|UB|', '0000130103', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT047', 'SANANT047', 'TXSATSTD', 'Gregory D Gordon Jr Md', 'Gregory', '', 'Gordon', 'MD', 'Sports Medicine', '', NULL, NULL, 'O', '7940 Floyd Curl Dr Ste 560', 'San Antonio', 'Bexar', 'TX', '78229', '2106927400', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'St Lukes Baptist Hospital', 'Methodist Hospital', NULL, 'HCFA|UB|', '0000130104', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT048', 'SANANT048', 'TXSATSTD', 'Grizelda Anguiano Md', 'Grizelda', '', 'Anguiano', 'MD', 'Hospitalist', '', NULL, NULL, 'O', '15316 Huebner Rd Ste 102', 'San Antonio', 'Bexar', 'TX', '78248', '2104799292', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130105', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT049', 'SANANT049', 'TXSATSTD', 'Guillermo A Reyes Md', 'Guillermo', '', 'Reyes', 'MD', 'Cardiology', '', NULL, NULL, 'O', '8093 Eckhert Rd', 'San Antonio', 'Bexar', 'TX', '78240', '2109491300', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Christus Santa Rosa Medical Center', NULL, 'HCFA|UB|', '0000130106', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT050', 'SANANT050', 'TXSATSTD', 'Helen F Konduris Otr', 'Helen', '', 'Konduris', 'OTR', 'Occupational Medicine', '', NULL, NULL, 'O', '9901 W Interstate 10 Ste 680', 'San Antonio', 'Bexar', 'TX', '78230', '2105582848', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130107', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('760596676', 'SANANT051', 'SANANT051', 'TXSATSTD', 'Hill Country Ear Nose And Throat Pa', 'Barbara', '', 'Beck', 'AUD', 'Audiology', '', NULL, NULL, 'O', '42 Gruene Park Dive', 'New Braunsfel', 'Comal', 'TX', '78130', '8306295830', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130108', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('760596676', 'SANANT052', 'SANANT052', 'TXSATSTD', 'Hill Country Ear Nose And Throat Pa', 'Charles', '', 'Lano Jr', 'MD', 'Sleep Medicine', '', NULL, NULL, 'O', '42 Gruene Park Dive', 'New Braunsfel', 'Comal', 'TX', '78130', '8306295830', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130109', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT053', 'SANANT053', 'TXSATSTD', 'Howard T Wang Md', 'Howard', '', 'Wang', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '333 N Santa Rosa Ave', 'san Antonio', 'Bexar', 'TX', '78207', '2107044100', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130110', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('200727082', 'SANANT054', 'SANANT054', 'TXSATSTD', 'Institute Of Plastic Surgery In San Antonio Pa', '', '', 'Institute Of Plastic Surgery In San Antonio Pa', '', 'Plastic Surgery', '', NULL, NULL, 'O', '4499 Medical Dr Ste 301', 'San Antonio', 'Bexar', 'TX', '78229', '2106923223', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130111', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('000000000', 'SANANT055', 'SANANT055', 'TXSATSTD', 'James Biasiolli Otr', 'James', '', 'Biasiololli', 'OTR', 'Occupational Medicine', '', NULL, NULL, 'O', '11212 State Hwy 151 Ste 150', 'San Antonio', 'Bexar', 'TX', '78251', '2108045400', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130112', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT056', 'SANANT056', 'TXSATSTD', 'James H Prieto Md', 'James', '', 'Prieto', 'MD', 'Colon and Rectal Surgery', '', NULL, NULL, 'O', '311 Camden St Ste 501', 'San Antonio', 'Bexar', 'TX', '78215', '2102126302', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'St Lukes Baptist Hospital', NULL, 'HCFA|UB|', '0000130113', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT057', 'SANANT057', 'TXSATSTD', 'James M Landeen Md', 'James', '', 'Landeen', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '4499 Medical Dr Ste 325', 'san Antonio', 'Bexar', 'TX', '78229', '2106920436', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'St Lukes Baptist Hospital', 'Methodist Childrens Hospital SW TX', NULL, 'HCFA|UB|', '0000130114', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT058', 'SANANT058', 'TXSATSTD', 'Jamie L Lynch Md', 'Jamie', '', 'Lynch', 'MD', 'Sports Medicine', '', NULL, NULL, 'O', '8715 Village Dr Ste 120', 'San Antonio', 'Bexar', 'TX', '78217', '2104775151', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', '', NULL, 'HCFA|UB|', '0000130115', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT059', 'SANANT059', 'TXSATSTD', 'Jay D Kerecman Md', 'Jay', '', 'Kerecman', 'MD', 'Hospitalist', '', NULL, NULL, 'O', '111 Dallas St', 'San Antonio', 'Bexar', 'TX', '78205', '2102977000', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Childrens Hospital of San Antonio', NULL, 'HCFA|UB|', '0000130116', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT060', 'SANANT060', 'TXSATSTD', 'Jennifer D Brody Md', 'Jennifer', '', 'Brody', 'MD', 'Hospitalist', '', NULL, NULL, 'O', '21 Spurs Ln Ste 230B', 'San Antonio', 'Bexar', 'TX', '78240', '2106907400', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'North Central Baptist Hospital', 'Methodist Stone Oak Hospital', NULL, 'HCFA|UB|', '0000130117', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT061', 'SANANT061', 'TXSATSTD', 'Jennifer L Montgomery Aud', 'Jennifer', '', 'Montgomery', 'AUD', 'Audiology', '', NULL, NULL, 'O', '7410 Broadway St', 'San Antonio', 'Bexar', 'TX', '78209', '2108297438', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130118', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT062', 'SANANT062', 'TXSATSTD', 'Jennifer Schreiner Ma', 'Jennifer', '', 'Schreiner', 'MA', 'Audiology', '', NULL, NULL, 'O', '8300 Floyd Curl Dr Ste 6B', 'San Antonio', 'Bexar', 'TX', '78229', '2104509950', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130119', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT063', 'SANANT063', 'TXSATSTD', 'Jim Hsiang Md', 'Jim', '', 'Hsiang', 'MD', 'Radiation Oncology', '', NULL, NULL, 'O', '9102 Floyd Curl Dr', 'San Antonio', 'Bexar', 'TX', '78240', '2102470888', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Methodist Hospital', NULL, 'HCFA|UB|', '0000130120', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT064', 'SANANT064', 'TXSATSTD', 'Jodi Mclean', 'Jodi', '', 'Mclean', 'AUD', 'Audiology', '', NULL, NULL, 'O', '4402 Vance Jackson Ste 156', 'San Antonio', 'Bexar', 'TX', '78230', '2103410457', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130121', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT065', 'SANANT065', 'TXSATSTD', 'John D Young Iii Dds', 'John', '', 'Young', 'MD', 'Oral/Maxillofacial Surgery', '', NULL, NULL, 'O', '2829 Babcock Rd Ste 126', 'San Antonio', 'Bexar', 'TX', '78229', '2106929556', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'North Central Baptist Hospital', NULL, 'HCFA|UB|', '0000130122', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT066', 'SANANT066', 'TXSATSTD', 'John K Gresham Md', 'John', '', 'Gresham', 'MD', 'Cardiology', '', NULL, NULL, 'O', '19276 Stone Oak PKWY Ste 103', 'San Antonio', 'Bexar', 'TX', '78258', '2104990448', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'St Lukes Baptist Hospital', NULL, 'HCFA|UB|', '0000130123', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT067', 'SANANT067', 'TXSATSTD', 'John P Schmitz Dds', 'John', '', 'Schmitz', 'MD', 'Oral/Maxillofacial Surgery', '', NULL, NULL, 'O', '3519 Paesanos PKWY Ste 102', 'San Antonio', 'Bexar', 'TX', '78231', '2104449312', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'North Central Baptist Hospital', NULL, 'HCFA|UB|', '0000130124', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT068', 'SANANT068', 'TXSATSTD', 'John R Chance Iii Md', 'John', '', 'Chance', 'MD', 'Sports Medicine', '', NULL, NULL, 'O', '8715 Village Dr Ste 120', 'San Antonio', 'Bexar', 'TX', '78217', '2104775151', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Northeast Baptist Hospital', NULL, 'HCFA|UB|', '0000130125', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT069', 'SANANT069', 'TXSATSTD', 'John S Matlock Md', 'John', '', 'Matlock', 'MD', 'Geriatrics', '', NULL, NULL, 'O', '8401 Datapoint Dr Ste 401', 'San Antonio', 'Bexar', 'TX', '78229', '2109492202', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Meth Spec Trans Hospital', 'St Lukes Baptist Hospital', NULL, 'HCFA|UB|', '0000130126', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT070', 'SANANT070', 'TXSATSTD', 'Jorge Magallon Md', 'Jorge', '', 'Magallon', 'MD', 'Cardiology', '', NULL, NULL, 'O', '311 Camden St Ste 102', 'San Antonio', 'Bexar', 'TX', '78215', '2102819800', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Beth Israel Deaconess Medical Center', NULL, 'HCFA|UB|', '0000130127', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742613730', 'SANANT071', 'SANANT071', 'TXSATSTD', 'Julio E Ortiz Md', 'Julio', '', 'Ortiz', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '1303 McCullough Ave Ste 226', 'san Antonio', 'Bexar', 'TX', '78212', '2102255164', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Chi St Lukes Baylor Col', NULL, 'HCFA|UB|', '0000130128', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT072', 'SANANT072', 'TXSATSTD', 'Katharine M Johnson Md', 'Katharine', '', 'Johnson', 'MD', 'Hospitalist', '', NULL, NULL, 'O', '333 N Santa Rosa Ave', 'San Antonio', 'Bexar', 'TX', '78207', '2107042011', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'North Central Baptist Hospital', NULL, 'HCFA|UB|', '0000130129', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT073', 'SANANT073', 'TXSATSTD', 'Kevin M Mcdonnell Md', 'Kevin', '', 'Mcdonnell', 'MD', 'Diagnostic Radiology', '', NULL, NULL, 'O', '13663 Treasure Trail Dr', 'San Antonio', 'Bexar', 'TX', '78232', '8005400291', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130130', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT074', 'SANANT074', 'TXSATSTD', 'Khusro Rashid Md', 'Khusro', '', 'Rashid', 'MD', 'Hospitalist', '', NULL, NULL, 'O', '6111 S Zarzamora St', 'San Antonio', 'Bexar', 'TX', '78211', '2109276900', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'St Lukes Baptist Hospital', NULL, 'HCFA|UB|', '0000130131', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT075', 'SANANT075', 'TXSATSTD', 'Kimatha Grice Otr', 'Kimatha', '', 'Grice', 'OTR', 'Occupational Medicine', '', NULL, NULL, 'O', '8300 Floyd Curl Dr Ste 3rd FL', 'San Antonio', 'Bexar', 'TX', '78229', '2104509680', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130132', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT076', 'SANANT076', 'TXSATSTD', 'Lakshmi P Vemulapalli Md', 'Lakshmi', '', 'Vemulapalli', 'MD', 'Cardiology', '', NULL, NULL, 'O', '1200 Brooklyn Ave Ste 200', 'San Antonio', 'Bexar', 'TX', '78212', '2102254566', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'North Central Baptist Hospital', NULL, 'HCFA|UB|', '0000130133', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT077', 'SANANT077', 'TXSATSTD', 'Leonard E Deal Md', 'Leonard', '', 'Deal', 'MD', 'Hospitalist', '', NULL, NULL, 'O', '8715 Village Dr Ste 514', 'San Antonio', 'Bexar', 'TX', '78217', '2106563600', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Houston Methodist Hospital', NULL, 'HCFA|UB|', '0000130134', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT078', 'SANANT078', 'TXSATSTD', 'Mathew Gordon Dds', 'Mathew', '', 'Gordon', 'MD', 'Oral/Maxillofacial Surgery', '', NULL, NULL, 'O', '235 E Hildebrand Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2108244501', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'North Central Baptist Hospital', 'Metropolitan Methodist Hospital', NULL, 'HCFA|UB|', '0000130135', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT079', 'SANANT079', 'TXSATSTD', 'Melva P Andrews Otr', 'Melva', '', 'Andrews', 'OTR', 'Occupational Medicine', '', NULL, NULL, 'O', '8403 Floyd Curl Dr Ste 1110', 'San Antonio', 'Bexar', 'TX', '78229', '2105678600', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130136', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT080', 'SANANT080', 'TXSATSTD', 'Michael A Barnett Md', 'Michael', '', 'Barnett', 'MD', 'Cardiology', '', NULL, NULL, 'O', '12446 W Ave Ste 200', 'San Antonio', 'Bexar', 'TX', '78216', '2105251668', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'St Lukes Baptist Hospital', 'Christus Santa Rosa Medical Center', NULL, 'HCFA|UB|', '0000130137', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT081', 'SANANT081', 'TXSATSTD', 'Michael Baumholtz Md', 'Michael', '', 'Baumholtz', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '11212 State Hwy 151 Ste 260', 'san Antonio', 'Bexar', 'TX', '78251', '2106144320', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'St Lukes Baptist Hospital', NULL, 'HCFA|UB|', '0000130138', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('200727082', 'SANANT082', 'SANANT082', 'TXSATSTD', 'Michael E Decherd Md', 'Michael', '', 'Decherd', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '414 W Sunset Rd Ste 215', 'san Antonio', 'Bexar', 'TX', '78209', '2104954100', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'St Lukes Baptist Hospital', NULL, 'HCFA|UB|', '0000130139', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT083', 'SANANT083', 'TXSATSTD', 'Michael M Heckman Md', 'Michael', '', 'Heckman', 'MD', 'Sports Medicine', '', NULL, NULL, 'O', '9502 Huebner Rd Ste 301', 'San Antonio', 'Bexar', 'TX', '78240', '2102280435', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'St Lukes Baptist Hospital', 'Houston Methodist Hospital', NULL, 'HCFA|UB|', '0000130140', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('454288136', 'SANANT084', 'SANANT084', 'TXSATSTD', 'Michele Thiet', 'Michele', '', 'Thiet', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '8550 Datapoint Dr Ste 250', 'San Antonio', 'Bexar', 'TX', '78229', '2106160862', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130141', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT085', 'SANANT085', 'TXSATSTD', 'Ortegon P Delio Md', 'Ortegon', '', 'Delio', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '11212 State Hwy 151 Ste 260', 'san Antonio', 'Bexar', 'TX', '78251', '2106144320', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'St Lukes Baptist Hospital', NULL, 'HCFA|UB|', '0000130142', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT086', 'SANANT086', 'TXSATSTD', 'Oscar Ochoa Md', 'Oscar', '', 'Ochoa', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '9635 Huebner Rd', 'san Antonio', 'Bexar', 'TX', '78240', '2106921181', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'St Lukes Baptist Hospital', 'Methodist Childrens Hospital SW TX', NULL, 'HCFA|UB|', '0000130143', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('043655732', 'SANANT087', 'SANANT087', 'TXSATSTD', 'Pablo M Feuillet Mdpa', 'Pablo', '', 'Feuillet', 'MD', 'Infectious Disease', '', NULL, NULL, 'O', '155 E Sonterra Blvd Ste 111', 'San Antonio', 'Bexar', 'TX', '78258', '2104917700', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130144', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT088', 'SANANT088', 'TXSATSTD', 'Pamela Meyer Otr', 'Pamela', '', 'Meyer', 'OTR', 'Occupational Medicine', '', NULL, NULL, 'O', '400 Concord Plaza Dr Ste 130', 'San Antonio', 'Bexar', 'TX', '78216', '2108045530', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Christus Santa Rosa Medical Center', NULL, 'HCFA|UB|', '0000130145', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('454288136', 'SANANT089', 'SANANT089', 'TXSATSTD', 'Patrick J Schaner Md', 'Patrick', '', 'Schaner', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '525 Oak Centre Dr Ste 260', 'San Antonio', 'Bexar', 'TX', '78258', '2104962639', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'North Central Baptist Hospital', '', NULL, 'HCFA|UB|', '0000130146', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT090', 'SANANT090', 'TXSATSTD', 'Paul S Saenz Do', 'Paul', '', 'Saenz', 'MD', 'Sports Medicine', '', NULL, NULL, 'O', '5921 Broadway St', 'San Antonio', 'Bexar', 'TX', '78209', '2108828326', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'St Lukes Baptist Hospital', NULL, 'HCFA|UB|', '0000130147', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT091', 'SANANT091', 'TXSATSTD', 'Peter T H Wang Md', 'Peter', '', 'Wang', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '4499 Medical Dr Ste 347', 'san Antonio', 'Bexar', 'TX', '78229', '2106155787', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Childrens Hospital of San Antonio', NULL, 'HCFA|UB|', '0000130148', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742981597', 'SANANT092', 'SANANT092', 'TXSATSTD', 'Pulmonary Consultants Of San Antonio Pa', '', '', 'Pulmonary Consultants Of San Antonio Pa', '', 'Critical Care', '', NULL, NULL, 'O', '7950 Floyd Curl Dr Ste 620', 'San Antonio', 'Bexar', 'TX', '78229', '2106920361', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', '', NULL, 'HCFA|UB|', '0000130149', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742332650', 'SANANT093', 'SANANT093', 'TXSATSTD', 'Radiation Oncology Of San Antonio', 'Marta', '', 'Dahiya', 'MD', 'Radiation Oncology', '', NULL, NULL, 'O', '7718 Louis Pasteur CT Ste 101', 'San Antonio', 'Bexar', 'TX', '78229', '2104479060', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'North Central Baptist Hospital', '', NULL, 'HCFA|UB|', '0000130150', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742332650', 'SANANT094', 'SANANT094', 'TXSATSTD', 'Radiation Oncology Of San Antonio', 'Rajiv', '', 'Dahiya', 'MD', 'Radiation Oncology', '', NULL, NULL, 'O', '7718 Louis Pasteur CT Ste 101', 'San Antonio', 'Bexar', 'TX', '78229', '2104479060', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Mission Trail Baptist Hospital', NULL, 'HCFA|UB|', '0000130151', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742332650', 'SANANT095', 'SANANT095', 'TXSATSTD', 'Radiation Oncology Of San Antonio', 'Frank', '', 'Dancuart', 'MD', 'Radiation Oncology', '', NULL, NULL, 'O', '7718 Louis Pasteur CT Ste 101', 'San Antonio', 'Bexar', 'TX', '78229', '2104779060', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'North Central Baptist Hospital', NULL, 'HCFA|UB|', '0000130152', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT096', 'SANANT096', 'TXSATSTD', 'Radiology Associates Of New Braunsfel', '', '', 'Radiology Associates Of New Braunsfel', '', 'Diagnostic Radiology', '', NULL, NULL, 'O', '777 Loop 337', 'New Braunsfel', 'Comal', 'TX', '78130', '8306205747', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130153', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT097', 'SANANT097', 'TXSATSTD', 'Radiology Associates Of New Braunsfel', '', '', 'Radiology Associates Of New Braunsfel', '', 'Interventional Radiology', '', NULL, NULL, 'O', '777 Loop 337', 'New Braunsfel', 'Comal', 'TX', '78130', '8306205747', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130154', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT098', 'SANANT098', 'TXSATSTD', 'Radiology Associates Of New Braunsfel', '', '', 'Radiology Associates Of New Braunsfel', '', 'Neuroradiology', '', NULL, NULL, 'O', '777 Loop 337', 'New Braunsfel', 'Comal', 'TX', '78130', '8306205747', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130155', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT099', 'SANANT099', 'TXSATSTD', 'Radiology Associates Of New Braunsfel', '', '', 'Radiology Associates Of New Braunsfel', '', 'Pediatric Radiology', '', NULL, NULL, 'O', '777 Loop 337', 'New Braunsfel', 'Comal', 'TX', '78130', '8306205747', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130156', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT100', 'SANANT100', 'TXSATSTD', 'Radiology Associates Of New Braunsfel', '', '', 'Radiology Associates Of New Braunsfel', '', 'Radiology', '', NULL, NULL, 'O', '777 Loop 337', 'New Braunsfel', 'Comal', 'TX', '78130', '8306205747', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130157', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('741811168', 'SANANT101', 'SANANT101', 'TXSATSTD', 'Rajaram Bala Md', 'Rajaram', '', 'Bala', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '343 W Houston St Ste 1002', 'san Antonio', 'Bexar', 'TX', '78205', '2102253006', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Southwest General Hospital', NULL, 'HCFA|UB|', '0000130158', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('134226858', 'SANANT102', 'SANANT102', 'TXSATSTD', 'Raul Ramos Md', 'Raul', '', 'Ramos', 'MD', 'Colon and Rectal Surgery', '', NULL, NULL, 'O', '8300 Floyd Curl Dr Ste 4A', 'San Antonio', 'Bexar', 'TX', '78229', '2104509200', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Methodist Hospital', NULL, 'HCFA|UB|', '0000130159', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT103', 'SANANT103', 'TXSATSTD', 'Rebecca Best Aud', 'Rebecca', '', 'Best', 'AUD', 'Audiology', '', NULL, NULL, 'O', '8705 McCullough Ave Ste D9', 'San Antonio', 'Bexar', 'TX', '78216', '2103495999', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130160', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('453450178', 'SANANT104', 'SANANT104', 'TXSATSTD', 'Renata Ford Md Pa', 'Renata', '', 'Ford Md', 'MD', 'Thoracic Surgery', '', NULL, NULL, 'O', '502 Madison Oak Dr Ste 160', 'San Antonio', 'Bexar', 'TX', '78258', '2105195797', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130161', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT105', 'SANANT105', 'TXSATSTD', 'Robert E Novak Aud', 'Robert', '', 'Novak', 'AUD', 'Audiology', '', NULL, NULL, 'O', '8300 Floyd Curl Dr Ste 6B', 'San Antonio', 'Bexar', 'TX', '78229', '2104509950', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130162', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT106', 'SANANT106', 'TXSATSTD', 'Rosa I Vizcarra Md', 'Rosa', '', 'Vizcarra', 'MD', 'Geriatrics', '', NULL, NULL, 'O', '414 Navarro St Ste 1111', 'San Antonio', 'Bexar', 'TX', '78205', '2105685600', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Medical Center Hospital', NULL, 'HCFA|UB|', '0000130163', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT107', 'SANANT107', 'TXSATSTD', 'San Antonio Oral Surgery Pa', '', '', 'San Antonio Oral Surgery Pa', '', 'Oral/Maxillofacial Surgery', '', NULL, NULL, 'O', '3338 Oakwell Ct Ste 104', 'San Antonio', 'Bexar', 'TX', '78218', '2106563301', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130164', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT108', 'SANANT108', 'TXSATSTD', 'Schnitzler Cardiovascular Consultants Pllc', 'Sridevi', '', 'Pitta', 'MD', 'Cardiology', '', NULL, NULL, 'O', '8122 Datapoint Dr Ste 700', 'San Antonio', 'Bexar', 'TX', '78229', '2106150600', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'St Lukes Baptist Hospital', 'Methodist Texsan Hospital', NULL, 'HCFA|UB|', '0000130165', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT109', 'SANANT109', 'TXSATSTD', 'Seema Izfar Md', 'Seema', '', 'Izfar', 'MD', 'Colon and Rectal Surgery', '', NULL, NULL, 'O', '2829 Babcock Rd Ste 625', 'San Antonio', 'Bexar', 'TX', '78229', '2102987501', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130166', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT110', 'SANANT110', 'TXSATSTD', 'Sharon R Mcgeeney Do', 'Sharon', '', 'Mcgeeney', 'MD', 'Hospitalist', '', NULL, NULL, 'O', '4360 Greco Dr', 'San Antonio', 'Bexar', 'TX', '78222', '2106488200', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130167', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT111', 'SANANT111', 'TXSATSTD', 'Shaylon D Rettig Md', 'Shaylon', '', 'Rettig', 'MD', 'Sports Medicine', '', NULL, NULL, 'O', '3111 San Pedro Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2107327141', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Northeast Baptist Hospital', 'Methodist Childrens Hospital SW TX', NULL, 'HCFA|UB|', '0000130168', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742822413', 'SANANT112', 'SANANT112', 'TXSATSTD', 'South Texas Cardiothoracic And Vascular Surgical Associates', '', '', 'South Texas Cardiothoracic And Vascular Surgical Associates', '', 'Thoracic Surgery', '', NULL, NULL, 'O', '4330 Medical Dr Ste 325', 'San Antonio', 'Bexar', 'TX', '78229', '2106157700', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', NULL, 'HCFA|UB|', '0000130169', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT113', 'SANANT113', 'TXSATSTD', 'Stephen C Drukker Md', 'Stephen', '', 'Drukker', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '400 Concord Plaza Dr Ste 300', 'san Antonio', 'Bexar', 'TX', '78216', '2108045400', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'South Texas Spine and Surgical Hospital', NULL, 'HCFA|UB|', '0000130170', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT114', 'SANANT114', 'TXSATSTD', 'Steven P Solis Md', 'Steven', '', 'Solis', 'MD', 'Hospitalist', '', NULL, NULL, 'O', '4502 Medical Dr', 'San Antonio', 'Bexar', 'TX', '78229', '2103584000', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Northeast Baptist Hospital', 'University Health System', NULL, 'HCFA|UB|', '0000130171', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('861147141', 'SANANT115', 'SANANT115', 'TXSATSTD', 'Surgical Practices Of South Texas Pllc', 'Rolando', '', 'Saenz', 'MD', 'Colon and Rectal Surgery', '', NULL, NULL, 'O', '1200 Brooklyn Ave Ste 300', 'San Antonio', 'Bexar', 'TX', '78212', '2105453660', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Metroplitan Methodist Hospital', NULL, 'HCFA|UB|', '0000130172', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('861147141', 'SANANT116', 'SANANT116', 'TXSATSTD', 'Surgical Practices Of South Texas Pllc', 'Sara', '', 'Marciniszyn', 'MD', 'Colon and Rectal Surgery', '', NULL, NULL, 'O', '343 W Houston St Ste 705', 'San Antonio', 'Bexar', 'TX', '78205', '2105453660', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Childrens Hospital of San Antonio', NULL, 'HCFA|UB|', '0000130173', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT117', 'SANANT117', 'TXSATSTD', 'Susan M Gerik Otr', 'Susan', '', 'Gerik', 'OTR', 'Occupational Medicine', '', NULL, NULL, 'O', '400 Concord Plaza Dr Ste 130', 'San Antonio', 'Bexar', 'TX', '78216', '2108045400', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Christus Santa Rosa Medical Center', NULL, 'HCFA|UB|', '0000130174', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT118', 'SANANT118', 'TXSATSTD', 'Suzanna P Garza Md', 'Suzanna', '', 'Garza', 'MD', 'Hospitalist', '', NULL, NULL, 'O', '401 W Summit Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2107363126', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'St Lukes Baptist Hospital', NULL, 'HCFA|UB|', '0000130175', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT119', 'SANANT119', 'TXSATSTD', 'Tamara J Merchand Md', 'Tamara', '', 'Merchant', 'MD', 'Colon and Rectal Surgery', '', NULL, NULL, 'O', '2829 Babcock Rd Ste 625', 'San Antonio', 'Bexar', 'TX', '78229', '2102987501', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Childrens Hospital of San Antonio', NULL, 'HCFA|UB|', '0000130176', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT120', 'SANANT120', 'TXSATSTD', 'Teresa K Smith-Knuppel Md', 'Teresa', '', 'Smith Knuppel', 'MD', 'Geriatrics', '', NULL, NULL, 'O', '8647 Wurzbach Rd Bldg D', 'San Antonio', 'Bexar', 'TX', '78240', '2104487700', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', '', NULL, 'HCFA|UB|', '0000130177', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT121', 'SANANT121', 'TXSATSTD', 'Thomas T Jeneby Md', 'Thomas', '', 'Jeneby', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '7272 Wurzbach Rd Ste 801', 'san Antonio', 'Bexar', 'TX', '78240', '2102708595', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'North Central Baptist Hospital', NULL, 'HCFA|UB|', '0000130178', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('741586031', 'SANANT122', 'SANANT122', 'TXSATSTD', 'Tony Y Eng Md', 'Tony', '', 'Eng', 'MD', 'Radiation Oncology', '', NULL, NULL, 'O', '7979 Wurzbach Rd Ste G267', 'San Antonio', 'Bexar', 'TX', '78229', '2104501012', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Christus Santa Rosa Medical Center', NULL, 'HCFA|UB|', '0000130179', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT123', 'SANANT123', 'TXSATSTD', 'Village Drive Imaging Center', 'Terry', '', 'Collins', 'MD', 'Diagnostic Radiology', '', NULL, NULL, 'O', '8601 Village Dr Ste 111', 'San Antonio', 'Bexar', 'TX', '78217', '2106179950', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Houston Methodist Hospital', 'North Central Baptist Hospital', NULL, 'HCFA|UB|', '0000130180', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT124', 'SANANT124', 'TXSATSTD', 'William E Bode Md', 'William', '', 'Bode', 'MD', 'Colon and Rectal Surgery', '', NULL, NULL, 'O', '7950 Floyd Curl Dr Ste 101', 'San Antonio', 'Bexar', 'TX', '78229', '2106140880', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Methodist Hospital', NULL, 'HCFA|UB|', '0000130181', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('000000000', 'SANANT125', 'SANANT125', 'TXSATSTD', 'Woodward L Coleman Md', 'Woodward', '', 'Coleman', 'MD', 'Plastic Surgery', '', NULL, NULL, 'O', '8550 Datapoint Dr Ste 110', 'san Antonio', 'Bexar', 'TX', '78229', '2106155350', '', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', NULL, '0.00', '50.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', 'Baptist Medical Center', 'Nix Health Care System', NULL, 'HCFA|UB|', '0000130182', 0, 'N', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000315', 'IHP000315', 'ILCHIGSTD', 'Dupage Medical Group', 'Yoojin', NULL, 'Kim', 'MD', 'Endocrinology', NULL, NULL, NULL, 'O', '430 Warrenville Rd Ste Ste 310', 'Lisle', 'Dupage', 'IL', '60532', '6307894910', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1003072877', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000525', 'IHP000525', 'ILCHIGSTD', 'Dupage Medical Group', 'Anand', NULL, 'Shah', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '430 Warrenville Rd', 'Lisle', 'Dupage', 'IL', '60532', '6304326745', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003072893', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000858', 'IHP000858', 'ILCHIGSTD', NULL, 'Elias', NULL, 'Koliopoulos', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003074519', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000161', 'IHP000161', 'ILCHIGSTD', 'Dupage Medical Group', 'Elias', NULL, 'Koliopoulos', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '908 N Elm St Ste Ste 301', 'Hinsdale', 'Dupage', 'IL', '60521', '6303233540', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003074519', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000757', 'IHP000757', 'ILCHIGSTD', 'Edward Health Ventures', 'Richard', NULL, 'Mason', 'DO', 'General Surgery', NULL, NULL, NULL, 'O', '1 E County Line Rd', 'Sandwich', 'Dekalb', 'IL', '60548', '8157862722', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1003809625', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363879844', 'IHP000706', 'IHP000706', 'ILCHIGSTD', 'Suburban Gastroenterology', 'Dinesh', NULL, 'Jain', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '1243 Rickert Dr', 'Naperville', 'Dupage', 'IL', '60540', '6305276450', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1003857103', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000518', 'IHP000518', 'ILCHIGSTD', 'Dupage Medical Group', 'Ravi', NULL, 'Nemivant', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 102', 'Naperville', 'Dupage', 'IL', '60540', '6308716699', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1003883463', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000954', 'IHP000954', 'ILCHIGSTD', NULL, 'Ronald', NULL, 'Slonek ', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1003884610', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000218', 'IHP000218', 'ILCHIGSTD', 'Dupage Medical Group', 'Ronald', NULL, 'Slonek ', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '30 Stratford Dr', 'Bloomingdale', 'Dupage', 'IL', '60108', '6308932210', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1003884610', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000463', 'IHP000463', 'ILCHIGSTD', 'Dupage Medical Group', 'Agnieszka', NULL, 'Jackson', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1130 Stearns Rd ', 'Bartlett', 'Dupage', 'IL', '60103', '6305456050', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003924143', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363862327', 'IHP000693', 'IHP000693', 'ILCHIGSTD', 'Midwest Ent Consultants, Ltd', 'Carlane', NULL, 'Reese', 'PA', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '1247 Rickert Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6304202323', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003930611', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000492', 'IHP000492', 'ILCHIGSTD', 'Dupage Medical Group', 'Peena', NULL, 'Talati', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1130 Stearns Rd ', 'Bartlett', 'Dupage', 'IL', '60103', '6305456050', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003972761', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000384', 'IHP000384', 'ILCHIGSTD', 'Dupage Medical Group', 'Chris', NULL, 'Huang', 'MD', 'Orthopedic Surgery', 'Hand Surgery', NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 240', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6307901872', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013110519', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000672', 'IHP000672', 'ILCHIGSTD', 'Suburban Lung Associates', 'Michael', NULL, 'Keller', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1013164086', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000813', 'IHP000813', 'ILCHIGSTD', NULL, 'Laisvyde', NULL, 'Smajkic', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013943729', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000418', 'IHP000418', 'ILCHIGSTD', 'Dupage Medical Group', 'Shilpa', NULL, 'Cherukupally', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 220', 'Lombard', 'Dupage', 'IL', '60148', '6308738700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1013982578', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000798', 'IHP000798', 'ILCHIGSTD', 'Ehv-Edward Neuroscience Institute', 'Ali', NULL, 'Shaibani', 'MD', 'Radiology', NULL, NULL, NULL, 'O', '120 Spalding Dr  Ste 101', 'Naperville', 'Dupage', 'IL', '60540', '6305277730', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1023041720', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000659', 'IHP000659', 'ILCHIGSTD', 'Suburban Lung Associates', 'Timothy', NULL, 'Mcgee', 'DO', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1023061116', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000225', 'IHP000225', 'ILCHIGSTD', 'Dupage Medical Group', 'Gregory', NULL, 'Trevino', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 408', 'Naperville', 'Dupage', 'IL', '60540', '6307172630', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023078631', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000871', 'IHP000871', 'ILCHIGSTD', NULL, 'Gregory', NULL, 'Trevino', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023078631', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000893', 'IHP000893', 'ILCHIGSTD', NULL, 'John', NULL, 'Pace', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023110731', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000196', 'IHP000196', 'ILCHIGSTD', 'Dupage Medical Group', 'John', NULL, 'Pace', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '560 Belmont Ave', 'Carol Stream', 'Dupage', 'IL', '60188', '6306656500', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023110731', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000654', 'IHP000654', 'ILCHIGSTD', 'Suburban Lung Associates', 'Edward', NULL, 'Diamond', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1033161518', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000844', 'IHP000844', 'ILCHIGSTD', NULL, 'Daniel', NULL, 'Hrad', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033166921', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000146', 'IHP000146', 'ILCHIGSTD', 'Dupage Medical Group', 'Daniel', NULL, 'Hrad', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1948 three Farms Ave', 'Naperville', 'Dupage', 'IL', '60540', '6305271818', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033166921', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000590', 'IHP000590', 'ILCHIGSTD', 'Dupage Medical Group', 'Jordan', NULL, 'Moskoff', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '420 Warrenville Rd Ste Ste 230', 'Lisle', 'Dupage', 'IL', '60532', '6304326200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033228879', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363610208', 'IHP000250', 'IHP000250', 'ILCHIGSTD', 'Robert Millar, MD', 'Amy', NULL, 'Reed', 'NP', 'Family Practice', NULL, NULL, NULL, 'O', '1315 Macom Dr Ste Ste 203', 'Naperville', 'Will', 'IL', '60564', '6308984822', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1033549894', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000977', 'IHP000977', 'ILCHIGSTD', NULL, 'Thomas', NULL, 'Marshall', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043202054', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('362657618', 'IHP000176', 'IHP000176', 'ILCHIGSTD', 'Dupage Medical Group', 'Thomas', NULL, 'Marshall', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 310', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6307901792', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043202054', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000614', 'IHP000614', 'ILCHIGSTD', 'Dupage Medical Group', 'Kimberly', NULL, 'Murphy', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '430 Warrenville Rd Ste Ste 230', 'Lisle', 'Dupage', 'IL', '60532', '6304326200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043212418', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362684607', 'IHP000644', 'IHP000644', 'ILCHIGSTD', 'Dupage Urology Associates', 'Robert', NULL, 'Seo', 'MD', 'Urology', NULL, NULL, NULL, 'O', '1259 Rickert Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303691572', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043268329', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000917', 'IHP000917', 'ILCHIGSTD', NULL, 'Malcolm', NULL, 'Franklin', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043280589', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000125', 'IHP000125', 'ILCHIGSTD', 'Dupage Medical Group', 'Malcolm', NULL, 'Franklin', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '24020 W Riverwalk Ct Ste Ste 102', 'Plainfield', 'Will', 'IL', '60544', '8156762575', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043280589', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000328', 'IHP000328', 'ILCHIGSTD', 'Dupage Medical Group', 'Rafael', NULL, 'Piedra', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 208', 'Naperville', 'Dupage', 'IL', '60540', '6307172600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1043287196', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000750', 'IHP000750', 'ILCHIGSTD', 'Edward Health Ventures', 'Joseph', NULL, 'Kash', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '120 Spalding Dr  Ste 111', 'Naperville', 'Dupage', 'IL', '60540', '6305273788', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1043297971', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000810', 'IHP000810', 'ILCHIGSTD', NULL, 'Jean', NULL, 'Macary', 'NP', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043373160', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000974', 'IHP000974', 'ILCHIGSTD', NULL, 'Terry', NULL, 'May', 'DO', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1043394620', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000079', 'IHP000079', 'ILCHIGSTD', 'Dupage Medical Group', 'Terry', NULL, 'May', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '1948 three Farms Ave', 'Naperville', 'Dupage', 'IL', '60540', '6305271818', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1043394620', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000334', 'IHP000334', 'ILCHIGSTD', 'Dupage Medical Group', 'Bruce', NULL, 'Dillon', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '908 N Elm St Ste Ste 310', 'Hinsdale', 'Dupage', 'IL', '60521', '6307901700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053313841', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000245', 'IHP000245', 'ILCHIGSTD', 'Dupage Medical Group', 'Erin', NULL, 'Kopeny', 'PA', 'Physician Assistant', NULL, NULL, NULL, 'O', '1020 E Ogden Ave Ste Ste 115', 'Naperville', 'Dupage', 'IL', '60563', '6307178707', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053341743', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000862', 'IHP000862', 'ILCHIGSTD', NULL, 'Erin', NULL, 'Kopeny', 'PA', 'Physician Assistant', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053341743', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000461', 'IHP000461', 'ILCHIGSTD', 'Dupage Medical Group', 'Jill', NULL, 'Hill', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '12004 S Route 59', 'Plainfield', 'Will', 'IL', '60585', '8156762595', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053342741', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000887', 'IHP000887', 'ILCHIGSTD', NULL, 'Jennifer', NULL, 'Virant', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053371567', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000229', 'IHP000229', 'ILCHIGSTD', 'Dupage Medical Group', 'Jennifer', NULL, 'Virant', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '908 N Elm St Ste Ste 301', 'Hinsdale', 'Dupage', 'IL', '60521', '6303233540', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053371567', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000339', 'IHP000339', 'ILCHIGSTD', 'Dupage Medical Group', 'Amrit', NULL, 'Mangat', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 350', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6307901700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1053455386', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000442', 'IHP000442', 'ILCHIGSTD', 'Dupage Medical Group', 'Michelle', NULL, 'Brewer', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 240', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6309672000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053634329', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000589', 'IHP000589', 'ILCHIGSTD', 'Dupage Medical Group', 'Eric', NULL, 'Clymer', 'DO', 'Emergency Medicine', NULL, NULL, NULL, 'O', '420 Warrenville Rd Ste Ste 230', 'Lisle', 'Dupage', 'IL', '60532', '6304326200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '105400952', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('861128837', 'IHP000256', 'IHP000256', 'ILCHIGSTD', 'Generations Family Medicine', 'Barbara', NULL, 'Opalka', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '1816 Bay Scott Cir Ste Ste 112', 'Naperville', 'Dupage', 'IL', '60540', '6306378630', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1063404150', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000820', 'IHP000820', 'ILCHIGSTD', NULL, 'Shawn', NULL, 'Youngs', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063447944', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000836', 'IHP000836', 'ILCHIGSTD', NULL, 'Caroline', NULL, 'Wolfe', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063473031', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000235', 'IHP000235', 'ILCHIGSTD', 'Dupage Medical Group', 'Caroline', NULL, 'Wolfe', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 310', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6307901792', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063473031', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000419', 'IHP000419', 'ILCHIGSTD', 'Dupage Medical Group', 'Daniel', NULL, 'Danahey', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 330', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6304699200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1063499754', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000581', 'IHP000581', 'ILCHIGSTD', 'Dupage Medical Group', 'Karen', NULL, 'Weatherford-Zaluzec', 'NP', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '908 N Elm St Ste Ste 300', 'Hinsdale', 'Dupage', 'IL', '60521', '6309202229', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063526788', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000861', 'IHP000861', 'ILCHIGSTD', NULL, 'Erica', NULL, 'Attanasio', 'DO', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1063630895', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000073', 'IHP000073', 'ILCHIGSTD', 'Dupage Medical Group', 'Erica', NULL, 'Attanasio', 'DO', 'Pediatrics', NULL, NULL, NULL, 'O', '152 N Addison Rd Ste Ste 200', 'Elmhurst', 'Dupage', 'IL', '60126', '6308323100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1063630895', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000609', 'IHP000609', 'ILCHIGSTD', 'Dupage Medical Group', 'Yasser,M', NULL, 'Said', 'MD', 'Hospitalist', 'Internal Medicine', NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6308716699', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1063660652', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000981', 'IHP000981', 'ILCHIGSTD', NULL, 'Weiser', NULL, 'Cordero', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063689719', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000112', 'IHP000112', 'ILCHIGSTD', 'Dupage Medical Group', 'Weiser', NULL, 'Cordero', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3743 Highland Ave Ste Ste 1001', 'Downers Grove', 'Dupage', 'IL', '60515', '6304359888', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063689719', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000909', 'IHP000909', 'ILCHIGSTD', NULL, 'Kimberly', NULL, 'Scanlon', 'DO', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073526463', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000086', 'IHP000086', 'ILCHIGSTD', 'Dupage Medical Group', 'Kimberly', NULL, 'Scanlon', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '5600 S Wolf Rd Ste Ste 110', 'Western Springs', 'Cook', 'IL', '60558', '6302464155', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073526463', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000967', 'IHP000967', 'ILCHIGSTD', NULL, 'Stephen', NULL, ' Hung', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073589461', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000148', 'IHP000148', 'ILCHIGSTD', 'Dupage Medical Group', 'Stephen', NULL, ' Hung', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '801 N Cass Ave Ste Ste 300', 'Westmont', 'Dupage', 'IL', '60559', '6309636565', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073589461', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000304', 'IHP000304', 'ILCHIGSTD', 'Dupage Medical Group', 'Ashish', NULL, 'Bhatia', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '2155 Citygate Ln Ste Ste 225', 'Naperville', 'Dupage', 'IL', '60563', '6305475040', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1073595690', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000670', 'IHP000670', 'ILCHIGSTD', 'Suburban Lung Associates', 'Steven', NULL, 'Geller', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1073597795', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000551', 'IHP000551', 'ILCHIGSTD', 'Dupage Medical Group', 'Autumn', NULL, 'Roland', 'PA-C', 'Urology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 405', 'Winfield', 'Dupage', 'IL', '60190', '6305457565', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1073842993', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000978', 'IHP000978', 'ILCHIGSTD', NULL, 'Tushar', NULL, 'Gaonkar', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083604185', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000130', 'IHP000130', 'ILCHIGSTD', 'Dupage Medical Group', 'Tushar', NULL, 'Gaonkar', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1948 three Farms Ave', 'Naperville', 'Dupage', 'IL', '60540', '6305271818', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083604185', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000617', 'IHP000617', 'ILCHIGSTD', 'Dupage Medical Group', 'Ted', NULL, 'Shieh', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '430 Warrenville Rd Ste Ste 230', 'Lisle', 'Dupage', 'IL', '60532', '6304326200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083616460', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363737466', 'IHP000688', 'IHP000688', 'ILCHIGSTD', 'Naperville Ear, Nose and Throat', 'Leonard', NULL, 'Piazza', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '10 W Martin Ave  Ste 260', 'Naperville', 'Dupage', 'IL', '60540', '6303555668', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', 'Edward Hospital', NULL, NULL, 'HCFA|UB|', '1083633663', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000749', 'IHP000749', 'ILCHIGSTD', 'Edward Health Ventures', 'Alexander', NULL, 'Hantel', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '120 Spalding Dr  Ste 111', 'Naperville', 'Dupage', 'IL', '60540', '6305273788', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1083691349', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000635', 'IHP000635', 'ILCHIGSTD', 'Dupage Medical Group', 'Ehsan', NULL, 'Safari', 'DO', 'Radiology', NULL, NULL, NULL, 'O', '430 Pennsulvania Ave Ste Ste 110', 'Glen Ellyn', 'Dupage', 'IL', '60137', '6305457880', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083726319', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000559', 'IHP000559', 'ILCHIGSTD', 'Dupage Medical Group', 'Michael', NULL, 'Bercek', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '908 N Elm St Ste Ste 300', 'Hinsdale', 'Dupage', 'IL', '60521', '6309202229', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083728851', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000935', 'IHP000935', 'ILCHIGSTD', NULL, 'Monica', NULL, 'Mozwecz', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083756050', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000189', 'IHP000189', 'ILCHIGSTD', 'Dupage Medical Group', 'Monica', NULL, 'Mozwecz', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '5600 S Wolf Rd Ste Ste 110', 'Western Springs', 'Cook', 'IL', '60558', '7082464155', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083756050', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000828', 'IHP000828', 'ILCHIGSTD', NULL, 'Anthony', NULL, 'Fernandez', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083796239', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000123', 'IHP000123', 'ILCHIGSTD', 'Dupage Medical Group', 'Anthony', NULL, 'Fernandez', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '7409 Woodridge Dr', 'Woodridge', 'Dupage', 'IL', '60517', '6302411000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083796239', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000502', 'IHP000502', 'ILCHIGSTD', 'Dupage Medical Group', 'Christine', NULL, ' Sutton', 'PA', 'Physician Assistant', NULL, NULL, NULL, 'O', '1020 E Ogden Ave Ste Ste 115', 'Naperville', 'Dupage', 'IL', '60563', '6307078707', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083991939', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000822', 'IHP000822', 'ILCHIGSTD', NULL, 'Christine', NULL, ' Sutton', 'PA', 'Physician Assistant', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083991939', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000430', 'IHP000430', 'ILCHIGSTD', 'Dupage Medical Group', 'Christine', NULL, ' Sutton', 'PA', 'Physician Assistant', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste Ste 400', 'Naperville', 'Dupage', 'IL', '60540', '6309676000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083991939', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000524', 'IHP000524', 'ILCHIGSTD', 'Dupage Medical Group', 'Brian', NULL, 'Moran', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '430 Warrenville Rd', 'Lisle', 'Dupage', 'IL', '60532', '6304326745', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093712671', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000973', 'IHP000973', 'ILCHIGSTD', NULL, 'Tahmineh', NULL, 'Abbasian', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093716276', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000089', 'IHP000089', 'ILCHIGSTD', 'Dupage Medical Group', 'Tahmineh', NULL, 'Abbasian', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 210', 'Glen Ellyn', 'Dupage', 'IL', '60137', '6304697700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093716276', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000485', 'IHP000485', 'ILCHIGSTD', 'Dupage Medical Group', 'Victor', NULL, 'Rodriguez', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1948 three Farms Ave', 'Naperville', 'Dupage', 'IL', '60540', '6305478000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093740136', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000814', 'IHP000814', 'ILCHIGSTD', NULL, 'Matthew', NULL, 'Carducci', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093762338', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362985496', 'IHP000648', 'IHP000648', 'ILCHIGSTD', 'Advanced Heart Lipid Clinic', 'Enas', NULL, 'Enas', 'MD', 'Cardiovascular Diseases', NULL, NULL, NULL, 'O', '4121 Fairview Ave  Ste 103', 'Downers Grove', 'Dupage', 'IL', '60515', '6309601844', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093771040', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363995666', 'IHP000257', 'IHP000257', 'ILCHIGSTD', 'Waddah J. Hashem MD Ltd', 'Waddah', NULL, 'Hashem', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '1315 Macom Dr Ste 206', 'Naperville', 'Will', 'IL', '60564', '6309787015', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093771875', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000939', 'IHP000939', 'ILCHIGSTD', NULL, 'Panorea', NULL, 'Kukla', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093782617', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000177', 'IHP000177', 'ILCHIGSTD', 'Dupage Medical Group', 'Panorea', NULL, 'Kukla', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 210', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6304697700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093782617', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363082580', 'IHP000650', 'IHP000650', 'ILCHIGSTD', 'Hematology-Oncology Consultants', 'Fariborze', NULL, 'Barhamand', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '100 Spalding Dr  Ste 110', 'Naperville', 'Dupage', 'IL', '60540', '6303691501', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093810491', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000674', 'IHP000674', 'ILCHIGSTD', 'Suburban Lung Associates', 'Meena', NULL, 'Muruqappan', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093924037', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000514', 'IHP000514', 'ILCHIGSTD', 'Dupage Medical Group', 'Juan', NULL, 'Flores', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 102', 'Naperville', 'Dupage', 'IL', '60540', '6308716699', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093931909', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364270595', 'IHP000725', 'IHP000725', 'ILCHIGSTD', 'Riaz Baber, MD', 'Mazhar', NULL, 'Golewale', 'MD', 'Psychiatry', NULL, NULL, NULL, 'O', '1460 Bond St Ste 120', 'Naperville', 'Dupage', 'IL', '60563', '6308590120', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104048446', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000545', 'IHP000545', 'ILCHIGSTD', 'Dupage Medical Group', 'Cameron', NULL, 'Jirschele', 'DO', 'Urology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 405', 'Winfield', 'Dupage', 'IL', '60190', '6307901221', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104060110', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000021', 'IHP000021', 'ILCHIGSTD', 'Edward Health Ventures-Edward Medical Group ', 'Zvedana (Dana)', NULL, 'Bogojevic', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3033 Ogden Ave Ste 101', 'Lisle', 'Dupage', 'IL', '60532', '6306466200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104159896', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000416', 'IHP000416', 'ILCHIGSTD', 'Dupage Medical Group', 'Kevin', NULL, 'Wright', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1259 Rickert Dr Ste Ste 101', 'Naperville', 'Dupage', 'IL', '60540', '6303551300', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104813849', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000014', 'IHP000014', 'ILCHIGSTD', 'Edward Health Ventures-Sandwich Family Practice', 'Kenneth ', NULL, 'Kavanaugh', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '1 East County Line Rd', 'Sandwich', 'Dekalb', 'IL', '60548', '8157862722', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104819697', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000001', 'IHP000001', 'ILCHIGSTD', 'Edward Health Ventures', 'Christina', NULL, 'Bartz     ', 'PA', 'Internal Medicine', NULL, NULL, NULL, 'O', '120 Spalding Dr  Ste 310', 'Naperville', 'Dupage', 'IL', '60540', '6305275000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104826361', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000160', 'IHP000160', 'ILCHIGSTD', 'Dupage Medical Group', 'Robert', NULL, 'King', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1020 E Ogden Ave Ste Ste 115', 'Naperville', 'Dupage', 'IL', '60563', '6307178707', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104892041', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000953', 'IHP000953', 'ILCHIGSTD', NULL, 'Robert', NULL, 'King', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104892041', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000576', 'IHP000576', 'ILCHIGSTD', 'Dupage Medical Group', 'Reinaldo', NULL, 'Sanchez', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 340', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6308583200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104894773', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000053', 'IHP000053', 'ILCHIGSTD', 'Edward Health Ventures', 'Bob', NULL, 'William         ', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '16519 S Rt 59', 'Plainfield', 'Will', 'il', '60586', '6306465020', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1114111028', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000441', 'IHP000441', 'ILCHIGSTD', 'Dupage Medical Group', 'Magnus', NULL, 'Borgehammar', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste L10', 'Lombard', 'Dupage', 'IL', '60148', '6308738860', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114113768', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000599', 'IHP000599', 'ILCHIGSTD', 'Dupage Medical Group', 'Julia', NULL, 'Hernandez', 'MD', 'Hospitalist', 'Internal Medicine', NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6304699200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1114154853', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000621', 'IHP000621', 'ILCHIGSTD', 'Dupage Medical Group', 'Barbara', NULL, 'Koren', 'APN', 'Hospital based', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6303228300', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114218369', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000911', 'IHP000911', 'ILCHIGSTD', NULL, 'Leena', NULL, ' Raikar', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114242302', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000205', 'IHP000205', 'ILCHIGSTD', 'Dupage Medical Group', 'Leena', NULL, ' Raikar', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 310', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6307901792', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114242302', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000916', 'IHP000916', 'ILCHIGSTD', NULL, 'Magdalena', NULL, 'Fus', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114246782', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000128', 'IHP000128', 'ILCHIGSTD', 'Dupage Medical Group', 'Magdalena', NULL, 'Fus', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 310', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6307901792', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114246782', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000320', 'IHP000320', 'ILCHIGSTD', 'Dupage Medical Group', 'Andrea', NULL, 'Edwards', 'NP', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 208', 'Naperville', 'Dupage', 'IL', '60540', '6307172600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1114273786', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000399', 'IHP000399', 'ILCHIGSTD', 'Dupage Medical Group', 'Troy', NULL, 'Karlsson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1900 Ogden Ave Ste Ste 210', 'Aurora', 'Dupage', 'IL', '60504', '6303751900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1114913910', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('383646745', 'IHP000733', 'IHP000733', 'ILCHIGSTD', 'Phillips Eye Center', 'Bryan', 'J', 'Phillips', 'MD', 'Ophthalmology', '', '', NULL, 'O', '718 S Weber Rd', 'Bolingbrook', 'Will', 'IL', '60440', '6303784799', NULL, '718 S Weber Rd', 'Bolingbrook', 'Will', 'IL', '60440', '6303784799', '', '', NULL, '', '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', '', '', '', 'HCFA|UB|', '1114923497', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000558', 'IHP000558', 'ILCHIGSTD', 'Dupage Medical Group', 'Donald', NULL, 'Adeli', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 340', 'Glen Ellyn', 'Dupage', 'IL', '60137', '6308583200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114928397', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000062', 'IHP000062', 'ILCHIGSTD', 'Edward Health Ventures', 'Sara ', NULL, 'Dabrowski  ', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '1220 Hobson Rd Ste 104', 'Naperville', 'Dupage', 'IL', '60540', '6304161950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1124018817', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000804', 'IHP000804', 'ILCHIGSTD', NULL, 'Catherine', NULL, 'Wigder', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124088646', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000522', 'IHP000522', 'ILCHIGSTD', 'Dupage Medical Group', 'Andrew', NULL, 'Yu', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '3825 Highland Ave Ste Ste 310', 'Downers Grove', 'Dupage', 'IL', '60515', '6308716699', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124088653', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000496', 'IHP000496', 'ILCHIGSTD', 'Dupage Medical Group', 'Amy', NULL, 'Waterwall', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '801 N Cass Ave  Ste Ste 100', 'Westmont', 'Dupage', 'IL', '60559', '6304567455', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '112418053', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000582', 'IHP000582', 'ILCHIGSTD', 'Dupage Medical Group', 'Jacqueline', NULL, 'Webster', 'NP', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '231 S Gary Ave Ste Ste 114', 'Bloomingdale', 'Dupage', 'IL', '60108', '6308938585', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124181722', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000902', 'IHP000902', 'ILCHIGSTD', NULL, 'Katherine', NULL, 'Sikic', 'APN', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124269592', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000071', 'IHP000071', 'ILCHIGSTD', 'Dupage Medical Group', 'Katherine', NULL, 'Sikic', 'APN', 'Internal Medicine', NULL, NULL, NULL, 'O', '1964 Springbrook Square Dr Ste Ste 104', 'Naperville', 'Will', 'IL', '60564', '6309462565', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124269592', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000608', 'IHP000608', 'ILCHIGSTD', 'Dupage Medical Group', 'Charles,T', NULL, 'Yohannan', 'MD', 'Hospitalist', 'Internal Medicine', NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6304699200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1124279864', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000293', 'IHP000293', 'ILCHIGSTD', 'Dupage Medical Group', 'Jane', NULL, 'Luu', 'MD', 'Cardiology', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 400', 'Naperville', 'Dupage', 'IL', '60540', '6307182660', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124281423', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000131', 'IHP000131', 'ILCHIGSTD', 'Dupage Medical Group', 'Audrey', NULL, 'Geannopoulos', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1020 E Ogden Ave Ste Ste 115', 'Naperville', 'Dupage', 'IL', '60563', '6307178707', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124282546', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000830', 'IHP000830', 'ILCHIGSTD', NULL, 'Audrey', NULL, 'Geannopoulos', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124282546', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000554', 'IHP000554', 'ILCHIGSTD', 'Dupage Medical Group', 'Michael', NULL, 'Gaffud', 'MD', 'Vascular Surgery', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6304699200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1124289137', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000611', 'IHP000611', 'ILCHIGSTD', 'Dupage Medical Group', 'Nathan, R', NULL, 'Bolden', 'MD', 'Hospitalist', 'Internal Medicine', NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6304699200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1124292727', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000376', 'IHP000376', 'ILCHIGSTD', 'Dupage Medical Group', 'Deanna', NULL, 'Vasiliauskas', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste L10', 'Lombard', 'Dupage', 'IL', '60148', '6308738860', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124314422', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000859', 'IHP000859', 'ILCHIGSTD', NULL, 'Eliseo', NULL, 'Roquiz', 'DO', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1124339833', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000084', 'IHP000084', 'ILCHIGSTD', 'Dupage Medical Group', 'Eliseo', NULL, 'Roquiz', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '640 S Washington St Ste Ste 350', 'Naperville', 'Dupage', 'IL', '60540', '6307172646', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1124339833', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000539', 'IHP000539', 'ILCHIGSTD', 'Dupage Medical Group', 'John', 'A', 'Hamby', 'MD', 'General Surgery', '', '', NULL, 'O', '1200 S York Rd Ste Ste 4220', 'Elmhurst', 'Dupage', 'IL', '60126', '6307588838', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', '', '', '', 'HCFA|UB|', '1134108657', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000632', 'IHP000632', 'ILCHIGSTD', 'Dupage Medical Group', 'Uday,N', NULL, 'Narahari', 'MD', 'Radiology', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 110', 'Glen Ellyn', 'Dupage', 'IL', '60137', '6305457880', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134176332', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000538', 'IHP000538', 'ILCHIGSTD', 'Dupage Medical Group', 'James', NULL, 'Wielgolewski', 'MD', 'Colon and Rectal Surgery', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste Ste 100', 'Naperville', 'Dupage', 'IL', '60540', '6309610423', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1134193493', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000870', 'IHP000870', 'ILCHIGSTD', NULL, 'Grant', NULL, 'Sievertsen', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134197619', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('362657618', 'IHP000217', 'IHP000217', 'ILCHIGSTD', 'Dupage Medical Group', 'Grant', NULL, 'Sievertsen', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '908 N Elm St Ste Ste 301', 'Hinsdale', 'Dupage', 'IL', '60521', '6303233540', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134197619', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000527', 'IHP000527', 'ILCHIGSTD', 'Dupage Medical Group', 'Brinda', NULL, 'Joshi', 'DO', 'Rheumatology', NULL, NULL, NULL, 'O', '636 Raymond Dr Ste Ste 304', 'Naperville', 'Dupage', 'IL', '60563', '6302680200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1134390750', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000051', 'IHP000051', 'ILCHIGSTD', 'Edward Health Ventures', 'Douglas', NULL, 'Tran', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2007 95th St  Ste 112', 'Naperville', 'Will', 'IL', '60564', '6305277780', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1144270976', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000809', 'IHP000809', 'ILCHIGSTD', NULL, 'Gaurav', NULL, 'Vajaria', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144280769', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000509', 'IHP000509', 'ILCHIGSTD', 'Dupage Medical Group', 'Gaurav', NULL, 'Vajaria', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '24020 W Riverwalk Ct Ste Ste 102', 'Plainfield', 'Will', 'IL', '60544', '6305106929', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144280769', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000884', 'IHP000884', 'ILCHIGSTD', NULL, 'Jeanette', NULL, 'Edwards', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144295643', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000119', 'IHP000119', 'ILCHIGSTD', 'Dupage Medical Group', 'Jeanette', NULL, 'Edwards', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '152 N Addison Rd Ste Ste 200', 'Elmhurst', 'Dupage', 'IL', '60126', '6308323100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144295643', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000829', 'IHP000829', 'ILCHIGSTD', NULL, 'Ashok', NULL, 'Kumar', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144297011', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000163', 'IHP000163', 'ILCHIGSTD', 'Dupage Medical Group', 'Ashok', NULL, 'Kumar', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 310', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6307901792', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144297011', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000925', 'IHP000925', 'ILCHIGSTD', NULL, 'Mark', NULL, 'Weiss', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154382117', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000230', 'IHP000230', 'ILCHIGSTD', 'Dupage Medical Group', 'Mark', NULL, 'Weiss', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '500 E 22Nd St Ste Ste D', 'Lombard', 'Dupage', 'IL', '60148', '6306206322', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154382117', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('742527126', 'IHP000801', 'IHP000801', 'ILCHIGSTD', 'Robert M. Allar, M.D.', 'Robert', NULL, 'Allar', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste 203', 'Naperville', 'Dupage', 'IL', '60540', '6307171311', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1154395663', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000956', 'IHP000956', 'ILCHIGSTD', NULL, 'Sapan', NULL, ' Patel', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154530384', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000197', 'IHP000197', 'ILCHIGSTD', 'Dupage Medical Group', 'Sapan', NULL, ' Patel', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1800 N Main St', 'Wheaton', 'Dupage', 'IL', '60187', '6305106900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154530384', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000464', 'IHP000464', 'ILCHIGSTD', 'Dupage Medical Group', 'Renuka', NULL, 'Kalvani', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '7409 Woodridge Dr Ste Ste F', 'Woodridge', 'Dupage', 'IL', '60517', '6305453535', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154641074', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363879844', 'IHP000707', 'IHP000707', 'ILCHIGSTD', 'Suburban Gastroenterology', 'Darren', NULL, 'Kastin', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '1243 Rickert Dr', 'Naperville', 'Dupage', 'IL', '60540', '6305276450', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1164402244', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000141', 'IHP000141', 'ILCHIGSTD', 'Dupage Medical Group', 'Naira', NULL, 'Hashmi', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 408', 'Naperville', 'Dupage', 'IL', '60540', '6309612170', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164418729', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000936', 'IHP000936', 'ILCHIGSTD', NULL, 'Naira', NULL, 'Hashmi', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164418729', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000922', 'IHP000922', 'ILCHIGSTD', NULL, 'Marilyn', NULL, 'Mistry', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164457032', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000185', 'IHP000185', 'ILCHIGSTD', 'Dupage Medical Group', 'Marilyn', NULL, 'Mistry', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '640 S Washington St Ste Ste 350', 'Naperville', 'Dupage', 'IL', '60540', '6307172646', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164457032', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000661', 'IHP000661', 'ILCHIGSTD', 'Suburban Lung Associates', 'Keith', NULL, 'Warren', 'MD', 'Sleep Medicine', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1164493854', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000758', 'IHP000758', 'ILCHIGSTD', 'Edward Health Ventures', 'Jean ', NULL, 'Walsh  ', 'DO', 'Wound Care', NULL, NULL, NULL, 'O', '801 S Washington St Ste Wound Clinic', 'Naperville', 'Dupage', 'IL', '60540', '6305273002', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1164648614', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000776', 'IHP000776', 'ILCHIGSTD', 'Edward Health Ventures-Linden Oaks Medical Group', 'Lekshmi ', NULL, 'Venugopal', 'MD', 'Psychiatry', NULL, NULL, NULL, 'O', '3805 E Main St Ste M', 'St. Charles', 'Kane', 'IL', '60174', '6306465200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1164682597', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000748', 'IHP000748', 'ILCHIGSTD', 'Edward Health Ventures', 'William', NULL, 'Broderick', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '120 Spalding Dr  Ste 111', 'Naperville', 'Dupage', 'IL', '60540', '6305273788', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1164696464', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000972', 'IHP000972', 'ILCHIGSTD', NULL, 'Susan', NULL, 'Thompson', 'CCNS', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164771242', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000072', 'IHP000072', 'ILCHIGSTD', 'Dupage Medical Group', 'Susan', NULL, 'Thompson', 'CCNS', 'Internal Medicine', NULL, NULL, NULL, 'O', '1964 Springbrook Square Dr Ste Ste 104', 'Naperville', 'Will', 'IL', '60564', '6309462565', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164771242', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000105', 'IHP000105', 'ILCHIGSTD', 'Dupage Medical Group', 'Sheron', NULL, ' Brown', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1020 E Ogden Ave Ste Ste 214', 'Naperville', 'Dupage', 'IL', '60563', '6304161375', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174507560', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000961', 'IHP000961', 'ILCHIGSTD', NULL, 'Sheron', NULL, ' Brown', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174507560', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364365177', 'IHP000261', 'IHP000261', 'ILCHIGSTD', 'Dupage Medical Group', 'Sheron', NULL, ' Brown', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1020 E Ogden Ave Ste Ste 214', 'Naperville', 'Dupage', 'IL', '60563', '6304161375', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174507560', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000662', 'IHP000662', 'ILCHIGSTD', 'Suburban Lung Associates', 'Therese', NULL, 'Zeman', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1174539472', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000668', 'IHP000668', 'ILCHIGSTD', 'Suburban Lung Associates', 'Crystal', NULL, 'Otteman', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1174578629', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000583', 'IHP000583', 'ILCHIGSTD', 'Dupage Medical Group', 'Peter', NULL, 'Weeks', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste Ste 309', 'Naperville', 'Dupage', 'IL', '60540', '6305276360', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1174584130', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000533', 'IHP000533', 'ILCHIGSTD', 'Dupage Medical Group', 'Paul', NULL, 'Ellis', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste Ste 400', 'Naperville', 'Dupage', 'IL', '60540', '6309672225', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1174594873', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000934', 'IHP000934', 'ILCHIGSTD', NULL, 'Monica', NULL, 'Chirila', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174598189', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000109', 'IHP000109', 'ILCHIGSTD', 'Dupage Medical Group', 'Monica', NULL, 'Chirila', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1124 Stearns Rd', 'Bartlett', 'Dupage', 'IL', '60103', '6302137788', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174598189', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000875', 'IHP000875', 'ILCHIGSTD', NULL, 'James', NULL, 'Bell ', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174628374', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000097', 'IHP000097', 'ILCHIGSTD', 'Dupage Medical Group', 'James', NULL, 'Bell ', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '12004 S Route 59', 'Plainfield', 'Will', 'IL', '60585', '8154166620', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174628374', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000388', 'IHP000388', 'ILCHIGSTD', 'Dupage Medical Group', 'Vivek', NULL, 'Mohan', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 220', 'Lombard', 'Dupage', 'IL', '60148', '6309672225', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1174705321', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000030', 'IHP000030', 'ILCHIGSTD', 'Edward Health Ventures', 'Mark', NULL, 'Gomez', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '130 N Weber Rd  Ste 100', 'Bolingbrook', 'Will', 'IL', '60440', '6306465777', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1174728430', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000899', 'IHP000899', 'ILCHIGSTD', NULL, 'Julia', NULL, 'Andreoni', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184601148', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000093', 'IHP000093', 'ILCHIGSTD', 'Dupage Medical Group', 'Julia', NULL, 'Andreoni', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 130', 'Lombard', 'Dupage', 'IL', '60148', '6306274722', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184601148', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('202625707', 'IHP000271', 'IHP000271', 'ILCHIGSTD', 'Li Zhang, MD, Sc', 'Li', NULL, 'Zhang', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '5980 S Route 53 Ste B', 'Lisle', 'Dupage', 'IL', '60532', '6309688220', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1184611881', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000914', 'IHP000914', 'ILCHIGSTD', NULL, 'Louis', NULL, 'Montana', 'MD', 'General Surgery', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184698425', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000184', 'IHP000184', 'ILCHIGSTD', 'Dupage Medical Group', 'Louis', NULL, 'Montana', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 130', 'Lombard', 'Dupage', 'IL', '60148', '6306274722', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184698425', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364430139', 'IHP000732', 'IHP000732', 'ILCHIGSTD', 'Mary K Deherrera-Codo, MD', 'Falguni', NULL, 'Vasa', 'MD', 'Endocrinology', NULL, NULL, NULL, 'O', '720 S Brom Dr Ste 204', 'Naperville', 'Dupage', 'IL', '60540', '6305481332', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1184741951', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000446', 'IHP000446', 'ILCHIGSTD', 'Dupage Medical Group', 'Allen', NULL, 'Cuevas', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste L10', 'Lombard', 'Dupage', 'IL', '60148', '6308738860', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184812869', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000849', 'IHP000849', 'ILCHIGSTD', NULL, 'Dejan', NULL, 'Rikert', 'DO', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184870131', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000083', 'IHP000083', 'ILCHIGSTD', 'Dupage Medical Group', 'Dejan', NULL, 'Rikert', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '1800 N Main St', 'Wheaton', 'Dupage', 'IL', '60187', '6306656200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184870131', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000406', 'IHP000406', 'ILCHIGSTD', 'Dupage Medical Group', 'Kelly', NULL, 'Perillo', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '4115 Fairview Ave', 'Downers Grove', 'Dupage', 'IL', '60515', '6309681881', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194711838', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000660', 'IHP000660', 'ILCHIGSTD', 'Suburban Lung Associates', 'James', NULL, 'Moss', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194725291', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000886', 'IHP000886', 'ILCHIGSTD', NULL, 'Jennifer', NULL, 'Blount ', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194726513', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000102', 'IHP000102', 'ILCHIGSTD', 'Dupage Medical Group', 'Jennifer', NULL, 'Blount ', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 210', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6304697700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194726513', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000344', 'IHP000344', 'ILCHIGSTD', 'Dupage Medical Group', 'Judith', NULL, 'Bressler', 'MD', 'Gynecology', NULL, NULL, NULL, 'O', '231 S Gary Ave Ste Ste 114', 'Bloomingdale', 'Dupage', 'IL', '60108', '6308938585', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194726547', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362684607', 'IHP000641', 'IHP000641', 'ILCHIGSTD', 'Dupage Urology Associates', 'Paul', NULL, 'Lyon', 'MD', 'Urology', NULL, NULL, NULL, 'O', '1259 Rickert Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303691572', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194773465', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000323', 'IHP000323', 'ILCHIGSTD', 'Dupage Medical Group', 'Kashyap', NULL, 'Katwala', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 208', 'Naperville', 'Dupage', 'IL', '60540', '6307172600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194791194', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000449', 'IHP000449', 'ILCHIGSTD', 'Dupage Medical Group', 'Sarah', NULL, 'Doll', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1964 Springbrook Square Dr', 'Naperville', 'Will', 'IL', '60564', '6309462565', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194858423', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000982', 'IHP000982', 'ILCHIGSTD', NULL, 'Whitney', NULL, 'Mccall', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194867713', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000179', 'IHP000179', 'ILCHIGSTD', 'Dupage Medical Group', 'Whitney', NULL, 'Mccall', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2940 Rolling Ridge Dr Ste Ste 300', 'Naperville', 'Will', 'IL', '60564', '6306465800', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194867713', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000039', 'IHP000039', 'ILCHIGSTD', 'Ehv-Edward Medical Group', 'Madhavi', NULL, 'Manubolu  ', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1999 Springbrook Square Dr  Ste 101', 'Naperville', 'Will', 'IL', '60564', '6303053025', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194890459', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000156', 'IHP000156', 'ILCHIGSTD', 'Dupage Medical Group', 'Yasir', NULL, 'Kazmi', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 210', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6304697700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205062791', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000855', 'IHP000855', 'ILCHIGSTD', NULL, 'Edwin', NULL, 'Espinosa', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205801354', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000121', 'IHP000121', 'ILCHIGSTD', 'Dupage Medical Group', 'Edwin', NULL, 'Espinosa', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1124 Stearns Rd', 'Bartlett', 'Dupage', 'IL', '60103', '6302137788', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205801354', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000846', 'IHP000846', 'ILCHIGSTD', NULL, 'David', NULL, 'Labotka', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205803178', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000167', 'IHP000167', 'ILCHIGSTD', 'Dupage Medical Group', 'David', NULL, 'Labotka', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3743 Highland Ave Ste Ste 1001', 'Downers Grove', 'Dupage', 'IL', '60515', '6304359888', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205803178', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000847', 'IHP000847', 'ILCHIGSTD', NULL, 'David', NULL, 'Morris', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205803293', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000188', 'IHP000188', 'ILCHIGSTD', 'Dupage Medical Group', 'David', NULL, 'Morris', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 210', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6304697700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205803293', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000412', 'IHP000412', 'ILCHIGSTD', 'Dupage Medical Group', 'David', NULL, 'Tulipan', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '4115 Fairview Ave', 'Downers Grove', 'Dupage', 'IL', '60515', '6309681881', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205822921', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000907', 'IHP000907', 'ILCHIGSTD', NULL, 'Kevin', NULL, 'Regan', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205823275', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000207', 'IHP000207', 'ILCHIGSTD', 'Dupage Medical Group', 'Kevin', NULL, 'Regan', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '430 Warrenville Rd Ste Ste 210', 'Lisle', 'Dupage', 'IL', '60532', '6304326180', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205823275', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000618', 'IHP000618', 'ILCHIGSTD', 'Dupage Medical Group', 'Carissa', NULL, 'Tyo', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '430 Warrenville Rd Ste Ste 230', 'Lisle', 'Dupage', 'IL', '60532', '6304326200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205843398', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000345', 'IHP000345', 'ILCHIGSTD', 'Dupage Medical Group', 'Janet', NULL, 'Chin', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '430 Warrenville Rd Ste Ste 300', 'Lisle', 'Dupage', 'IL', '60532', '6303647850', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205862653', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('810660755', 'IHP000254', 'IHP000254', 'ILCHIGSTD', 'Apple a Day Pediatrics', 'James', NULL, 'Webb', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '84 Templeton Dr Ste Ste 106', 'Oswego', 'Kendall', 'IL', '60543', '6305547654', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205893419', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000570', 'IHP000570', 'ILCHIGSTD', 'Dupage Medical Group', 'Dwight', NULL, 'Kett', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '908 N Elm St Ste Ste 300', 'Hinsdale', 'Dupage', 'IL', '60521', '6309202229', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205940988', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000374', 'IHP000374', 'ILCHIGSTD', 'Dupage Medical Group', 'Brock', NULL, 'Gorman', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 240', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6305457801', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1208103136', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000460', 'IHP000460', 'ILCHIGSTD', 'Dupage Medical Group', 'Alyssa', NULL, 'Hermann', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste L10', 'Lombard', 'Dupage', 'IL', '60148', '6308738860', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215000567', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000028', 'IHP000028', 'ILCHIGSTD', 'Edward Health Ventures-Edward Medical Group', 'Fowzia', NULL, 'Ghouse', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2132 Deep Water Ln Ste 228', 'Naperville', 'Will', 'IL', '60564', '6309221400', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1215923826', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('205861109', 'IHP000274', 'IHP000274', 'ILCHIGSTD', 'Fox Valley Radiation Oncology', 'Oh-Hoon', NULL, 'Kwon                ', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste 111', 'Naperville', 'Dupage', 'IL', '60540', '6305273788', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1215981956', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000964', 'IHP000964', 'ILCHIGSTD', NULL, 'Sonya', NULL, ' Tolani', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215986997', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000223', 'IHP000223', 'ILCHIGSTD', 'Dupage Medical Group', 'Sonya', NULL, ' Tolani', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '430 Warrenville Rd Ste Ste 210', 'Lisle', 'Dupage', 'IL', '60532', '6304326180', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215986997', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363737466', 'IHP000685', 'IHP000685', 'ILCHIGSTD', 'Naperville Ear, Nose and Throat', 'Robert', NULL, 'Kany', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '10 W Martin Ave  Ste 260', 'Naperville', 'Dupage', 'IL', '60540', '6303555668', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', 'Edward Hospital', NULL, NULL, 'HCFA|UB|', '1215990106', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000281', 'IHP000281', 'ILCHIGSTD', 'Dupage Medical Group', 'Brian', NULL, 'Smart', 'MD', 'Allergy and Immunology', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 220', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6305457833', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1215997408', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000818', 'IHP000818', 'ILCHIGSTD', NULL, 'Robert', NULL, 'Janowitz', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225004492', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000817', 'IHP000817', 'ILCHIGSTD', NULL, 'Robert', NULL, 'Carpenter', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225010184', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000633', 'IHP000633', 'ILCHIGSTD', 'Dupage Medical Group', 'Jonathan', NULL, 'Nolan', 'MD', 'Radiology', NULL, NULL, NULL, 'O', '40 S Clay St Ste Ste LL10', 'Hinsdale', 'Dupage', 'IL', '60521', '6304326848', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225013246', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000876', 'IHP000876', 'ILCHIGSTD', NULL, 'James', NULL, 'Collins', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225066020', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000111', 'IHP000111', 'ILCHIGSTD', 'Dupage Medical Group', 'James', NULL, 'Collins', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '640 S Washington St Ste Ste 268', 'Naperville', 'Dupage', 'IL', '60540', '6309612710', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225066020', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000947', 'IHP000947', 'ILCHIGSTD', NULL, 'Richard', NULL, 'Mattis', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225086580', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000178', 'IHP000178', 'ILCHIGSTD', 'Dupage Medical Group', 'Richard', NULL, 'Mattis', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '375 W North Ave Ste Ste 330', 'Melrose Park', 'Cook', 'IL', '60160', '7084505060', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225086580', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362705494', 'IHP000266', 'IHP000266', 'ILCHIGSTD', 'Dupage Medical Group', 'Richard', NULL, 'Mattis', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '375 W North Ave Ste Ste 330', 'Melrose Park', 'Cook', 'IL', '60160', '7084505060', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225086580', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000549', 'IHP000549', 'ILCHIGSTD', 'Dupage Medical Group', 'Joseph', NULL, 'Oh', 'MD', 'Urology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 405', 'Winfield', 'Dupage', 'IL', '60190', '6307901221', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1225086663', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000552', 'IHP000552', 'ILCHIGSTD', 'Dupage Medical Group', 'Craig', NULL, 'Smith', 'MD', 'Urology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 405', 'Winfield', 'Dupage', 'IL', '60190', '6307901221', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225098031', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000596', 'IHP000596', 'ILCHIGSTD', 'Dupage Medical Group', 'Lisa', NULL, 'Dunning', 'MD', 'Hospitalist', 'Internal Medicine', NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6304699200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1225269053', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000605', 'IHP000605', 'ILCHIGSTD', 'Dupage Medical Group', 'Tad', NULL, 'Nair', 'MD', 'Hospitalist', 'Internal Medicine', NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6304699200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1225352727', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363879844', 'IHP000702', 'IHP000702', 'ILCHIGSTD', 'Suburban Gastroenterology', 'Caren', NULL, 'Corrigan', 'NP', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '1243 Rickert Dr', 'Naperville', 'Dupage', 'IL', '60540', '6305276450', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1225365794', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000904', 'IHP000904', 'ILCHIGSTD', NULL, 'Kathleen', NULL, 'Kicsak', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235105396', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000158', 'IHP000158', 'ILCHIGSTD', 'Dupage Medical Group', 'Kathleen', NULL, 'Kicsak', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 130', 'Lombard', 'Dupage', 'IL', '60148', '6306274722', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235105396', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000848', 'IHP000848', 'ILCHIGSTD', NULL, 'Debra', NULL, 'Schwartzers', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235107731', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000213', 'IHP000213', 'ILCHIGSTD', 'Dupage Medical Group', 'Debra', NULL, 'Schwartzers', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 130', 'Lombard', 'Dupage', 'IL', '60148', '6306274722', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235107731', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000398', 'IHP000398', 'ILCHIGSTD', 'Dupage Medical Group', 'Jennifer', NULL, 'Johnson', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '4115 Fairview Ave', 'Downers Grove', 'Dupage', 'IL', '60515', '6309681881', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235126962', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('383646745', 'IHP000734', 'IHP000734', 'ILCHIGSTD', 'Phillips Eye Center', 'Dawn', NULL, 'Phillips', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '718 S Weber Rd', 'Bolingbrook', 'Will', 'IL', '60440', '6303784799', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', 'Edward Hospital', NULL, NULL, 'HCFA|UB|', '1235293630', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000462', 'IHP000462', 'ILCHIGSTD', 'Dupage Medical Group', 'Dawnell', NULL, 'Ibsen', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 240', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6305457801', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235301458', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000637', 'IHP000637', 'ILCHIGSTD', 'Dupage Medical Group', 'Jennifer,V', NULL, 'Yilk', 'MD', 'Radiology', NULL, NULL, NULL, 'O', '430 Warrenville Rd Ste Ste 110', 'Lisle', 'Dupage', 'IL', '60532', '6309462060', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235325135', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000052', 'IHP000052', 'ILCHIGSTD', 'Edward Health Ventures', 'Kathryn (Kate)', NULL, 'Walker', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1247 Rickert Dr Ste 201', 'Naperville', 'Dupage', 'IL', '60540', '6303577979', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1235396201', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000901', 'IHP000901', 'ILCHIGSTD', NULL, 'Karla', NULL, 'Dorsey-Johnson', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245205731', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('362657618', 'IHP000115', 'IHP000115', 'ILCHIGSTD', 'Dupage Medical Group', 'Karla', NULL, 'Dorsey-Johnson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '640 S Washington St Ste Ste 350', 'Naperville', 'Dupage', 'IL', '60540', '6307172646', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245205731', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000879', 'IHP000879', 'ILCHIGSTD', NULL, 'James', NULL, 'Pollack', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245208099', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000201', 'IHP000201', 'ILCHIGSTD', 'Dupage Medical Group', 'James', NULL, 'Pollack', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '3743 Highland Ave Ste Ste 1003', 'Downers Grove', 'Dupage', 'IL', '60515', '6309646049', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245208099', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000392', 'IHP000392', 'ILCHIGSTD', 'Dupage Medical Group', 'Marc', NULL, 'Asselmeier', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 240', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6307901872', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245217272', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000777', 'IHP000777', 'ILCHIGSTD', 'Edward Health Ventures-Linden Oaks Medical Group', 'Walter ', NULL, 'Whang', 'MD', 'Psychiatry', NULL, NULL, NULL, 'O', '3540 Seven Bridges Dr Ste 230', 'Woodridge', 'Dupage', 'IL', '60517', '6309649400', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245217942', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000405', 'IHP000405', 'ILCHIGSTD', 'Dupage Medical Group', 'Timothy', NULL, 'Payne', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '15900 W 127th St Ste Ste 111', 'Lemont', 'Cook', 'IL', '60439', '6302437385', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245226968', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000952', 'IHP000952', 'ILCHIGSTD', NULL, 'Robert', NULL, 'Kemp', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245235100', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000157', 'IHP000157', 'ILCHIGSTD', 'Dupage Medical Group', 'Robert', NULL, 'Kemp', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1800 N Main St', 'Wheaton', 'Dupage', 'IL', '60187', '6306656500', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245235100', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364121495', 'IHP000722', 'IHP000722', 'ILCHIGSTD', 'Grossweiner and Blaszak, P.C.', 'Wayne', NULL, 'Blaszak', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste 405', 'Naperville', 'Dupage', 'IL', '60540', '6303556660', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245294008', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000746', 'IHP000746', 'ILCHIGSTD', 'Edward Health Ventures', 'Rosemarie', NULL, 'Batiste  ', 'APN', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste 111', 'Naperville', 'Dupage', 'IL', '60540', '6305273788', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245434851', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000444', 'IHP000444', 'ILCHIGSTD', 'Dupage Medical Group', 'Lucie', NULL, 'Casiello', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '801 N Cass Ave Ste Ste 100', 'Westmont', 'Dupage', 'IL', '60559', '6309672000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245493691', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000309', 'IHP000309', 'ILCHIGSTD', 'Dupage Medical Group', 'Te-Shao (Jeffrey)', NULL, 'Hsu', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '2155 Citygate Ln Ste Ste 225', 'Naperville', 'Dupage', 'IL', '60563', '6305475040', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1255300042', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000678', 'IHP000678', 'ILCHIGSTD', 'Suburban Lung Associates', 'Anna', NULL, 'Ivanenko', 'MD', 'SLEEP MEDICINE', NULL, NULL, NULL, 'O', '800 Biesterfield Rd  Ste 510', 'Elk Grove Village', 'Cook', 'IL', '60007', '8479813660', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1255308334', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000541', 'IHP000541', 'ILCHIGSTD', 'Dupage Medical Group', 'Harry', 'A', 'Siavelis', 'MD', 'General Surgery', '', '', NULL, 'O', '1200 S York Rd Ste Ste 4220', 'Elmhurst', 'Dupage', 'IL', '60126', '6307588838', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', '', 'HCFA|UB|', '1255310736', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362684607', 'IHP000643', 'IHP000643', 'ILCHIGSTD', 'Dupage Urology Associates', 'Misty', NULL, 'Wessing', 'PA', 'Urology', NULL, NULL, NULL, 'O', '1259 Rickert Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303691572', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1255341681', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000962', 'IHP000962', 'ILCHIGSTD', NULL, 'Sonal', NULL, ' Patel', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255418026', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000081', 'IHP000081', 'ILCHIGSTD', 'Dupage Medical Group', 'Sonal', NULL, ' Patel', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '30 Stratford Dr', 'Bloomingdale', 'Dupage', 'IL', '60108', '6308932210', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255418026', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000815', 'IHP000815', 'ILCHIGSTD', NULL, 'Louis', NULL, 'Montana', 'MD', 'General Surgery', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1255421558', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000340', 'IHP000340', 'ILCHIGSTD', 'Dupage Medical Group', 'Louis', NULL, 'Montana', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste Ste 100', 'Naperville', 'Dupage', 'IL', '60540', '6307901700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1255421558', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000778', 'IHP000778', 'ILCHIGSTD', 'Edward Health Ventures-Linden Oaks Medical Group', 'Courtney ', NULL, 'Cowan', 'APN', 'Psychiatry', NULL, NULL, NULL, 'O', '3540 Seven Bridges Dr Ste 230', 'Woodridge', 'Dupage', 'IL', '60517', '6309649400', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1255635991', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000408', 'IHP000408', 'ILCHIGSTD', 'Dupage Medical Group', 'Richard', NULL, 'Rosseau', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 240', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6307901872', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1265400253', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000215', 'IHP000215', 'ILCHIGSTD', 'Dupage Medical Group', 'Sonal', NULL, 'Shah Rhodes', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1020 E Ogden Ave Ste Ste 115', 'Naperville', 'Dupage', 'IL', '60563', '6307178707', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265400972', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000963', 'IHP000963', 'ILCHIGSTD', NULL, 'Sonal', NULL, 'Shah Rhodes', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265400972', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000287', 'IHP000287', 'ILCHIGSTD', 'Dupage Medical Group', 'Chris', NULL, 'Geannopoulos', 'MD', 'Cardiology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 300', 'Winfield', 'Dupage', 'IL', '60190', '6309338100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1265407076', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000508', 'IHP000508', 'ILCHIGSTD', 'Dupage Medical Group', 'Heidee', NULL, 'Kalmar', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '636 Raymond Dr Ste Ste 300', 'Naperville', 'Dupage', 'IL', '60563', '6305106929', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265408421', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000957', 'IHP000957', 'ILCHIGSTD', NULL, 'Scott', NULL, 'Love', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265409197', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000173', 'IHP000173', 'ILCHIGSTD', 'Dupage Medical Group', 'Scott', NULL, 'Love', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1948 three Farms Ave', 'Naperville', 'Dupage', 'IL', '60540', '6305271818', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265409197', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364113345', 'IHP000718', 'IHP000718', 'ILCHIGSTD', 'Womens Center For Health', 'Christopher', NULL, 'Olson', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1220 Hobson Rd Ste Ste 116', 'Naperville', 'Dupage', 'IL', '60540', '6304163300', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1265422448', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000892', 'IHP000892', 'ILCHIGSTD', NULL, 'John', NULL, 'Lee', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265449722', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000170', 'IHP000170', 'ILCHIGSTD', 'Dupage Medical Group', 'John', NULL, 'Lee', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1220 Hobson Rd Ste Ste 204', 'Naperville', 'Dupage', 'IL', '60540', '6304167766', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265449722', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000297', 'IHP000297', 'ILCHIGSTD', 'Dupage Medical Group', 'Mark', NULL, 'Ottolin', 'MD', 'Cardiology', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 212', 'Naperville', 'Dupage', 'IL', '60540', '6303574111', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1265525729', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363016210', 'IHP000246', 'IHP000246', 'ILCHIGSTD', 'Naperville Family Practice', 'Krishna', NULL, 'Bathina', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '720 S Brom Ct Ste Ste 101', 'Naperville', 'Dupage', 'IL', '60540', '6303558900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1265548093', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('320114670', 'IHP000069', 'IHP000069', 'ILCHIGSTD', 'Access Pediatrics, Ltd', 'Manju', NULL, 'Akhand', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '391 Quadrangle Dr Ste Ste N7', 'Bolingbrook', 'Will', 'IL', '60440', '6306791275', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1265570311', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000562', 'IHP000562', 'ILCHIGSTD', 'Dupage Medical Group', 'Phyllis', NULL, 'Chang', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 340', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6308583200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265654735', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000409', 'IHP000409', 'ILCHIGSTD', 'Dupage Medical Group', 'Kenneth', NULL, 'Sanders', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '100 Spalding Dr  Ste 3rd Fl', 'Naperville', 'Dupage', 'IL', '60540', '6303558000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275501777', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000563', 'IHP000563', 'ILCHIGSTD', 'Dupage Medical Group', 'Jaclynn', NULL, 'Clasen', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 340', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6308583200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275508731', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000802', 'IHP000802', 'ILCHIGSTD', NULL, 'Adelbert', NULL, 'Duvel', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275508772', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000282', 'IHP000282', 'ILCHIGSTD', 'Dupage Medical Group', 'Thomas', NULL, 'Van Osdol', 'MD', 'Allergy and Immunology', NULL, NULL, NULL, 'O', '24600 W 127th St Ste Ste 225', 'Plainfield', 'Will', 'IL', '60585', '6305457833', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275514366', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000010', 'IHP000010', 'ILCHIGSTD', 'Edward Health Ventures', 'Joseph', NULL, 'Giordano', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '2007 95th St  Ste 105', 'Naperville', 'Will', 'IL', '60564', '6306466920', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275520934', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000882', 'IHP000882', 'ILCHIGSTD', NULL, 'Jason', NULL, 'Griffin', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275551582', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000132', 'IHP000132', 'ILCHIGSTD', 'Dupage Medical Group', 'Jason', NULL, 'Griffin', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '908 N Elm St Ste Ste 301', 'Hinsdale', 'Dupage', 'IL', '60521', '6303233540', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275551582', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000772', 'IHP000772', 'ILCHIGSTD', 'Edward Health Ventures-Linden Oaks Medical Group', 'Barry ', NULL, 'Rabin', 'MD', 'Psychiatry', NULL, NULL, NULL, 'O', '1335 N Mill St Ste 100', 'Naperville', 'Dupage', 'IL', '60563', '6306468000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275562779', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364411737', 'IHP000258', 'IHP000258', 'ILCHIGSTD', 'Zofia Cygan, MD', 'Zofia', NULL, 'Cygan', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '640 S Washington St Ste 212', 'Naperville', 'Dupage', 'IL', '60540', '6303556040', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275627614', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000290', 'IHP000290', 'ILCHIGSTD', 'Dupage Medical Group', 'Sujith', NULL, 'Kalathiveetil', 'MD', 'Cardiology', NULL, NULL, NULL, 'O', '100 Spalding Dr  Ste Ste 400', 'Naperville', 'Dupage', 'IL', '60540', '6307182660', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275650632', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000741', 'IHP000741', 'ILCHIGSTD', 'Edward Neuroscience Institute', 'Michael', NULL, 'Caron', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste 101', 'Naperville', 'Dupage', 'IL', '60540', '6305272700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275738023', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000742', 'IHP000742', 'ILCHIGSTD', 'Elnhurst Neuroscience Institute', 'Michael', NULL, 'Caron', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'O', '1200 S York Rd Ste 3160', 'Elmhurst', 'Dupage', 'IL', '60126', '3312219090', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275738023', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000396', 'IHP000396', 'ILCHIGSTD', 'Dupage Medical Group', 'Michael', NULL, 'Coffel', 'NP', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 240', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6307901872', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275795866', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000358', 'IHP000358', 'ILCHIGSTD', 'Dupage Medical Group', 'Jennifer', NULL, 'Ahmadian', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '636 Raymond Dr Ste Ste 304', 'Naperville', 'Dupage', 'IL', '60563', '6309614150', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1285635466', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000782', 'IHP000782', 'ILCHIGSTD', 'Edward Medical Group-General Surgery', 'Robert', NULL, 'Payton', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '10 W Martin Ave  Ste 225', 'Naperville', 'Dupage', 'IL', '60540', '6303555633', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1285748582', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000913', 'IHP000913', 'ILCHIGSTD', NULL, 'Lisa', NULL, 'Rondeau', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285828293', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000209', 'IHP000209', 'ILCHIGSTD', 'Dupage Medical Group', 'Lisa', NULL, 'Rondeau', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1124 Stearns Rd', 'Bartlett', 'Dupage', 'IL', '60103', '6302137788', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285828293', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000834', 'IHP000834', 'ILCHIGSTD', NULL, 'Brian', NULL, 'Oleary', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295702439', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000195', 'IHP000195', 'ILCHIGSTD', 'Dupage Medical Group', 'Brian', NULL, 'Oleary', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1964 Springbrook Square Dr Ste Ste 104', 'Naperville', 'Will', 'IL', '60564', '6309462565', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295702439', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000765', 'IHP000765', 'ILCHIGSTD', 'Edward Health Ventures-Linden Oaks Medical Group', 'Shyamsunder ', NULL, 'Chakilum', 'MD', 'Psychiatry', NULL, NULL, NULL, 'O', '1335 N Mill St Ste 100', 'Naperville', 'Dupage', 'IL', '60563', '6306468000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1295706521', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000354', 'IHP000354', 'ILCHIGSTD', 'Dupage Medical Group', 'Ernest', NULL, 'Dejesus', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 405', 'Winfield', 'Dupage', 'IL', '60190', '6308738889', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1295737088', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000414', 'IHP000414', 'ILCHIGSTD', 'Dupage Medical Group', 'Vincent', NULL, 'Walsh', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 300', 'Naperville', 'Dupage', 'IL', '60540', '6307901872', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1295760163', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000923', 'IHP000923', 'ILCHIGSTD', NULL, 'Mark', NULL, 'Isoniemi', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295779239', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000152', 'IHP000152', 'ILCHIGSTD', 'Dupage Medical Group', 'Mark', NULL, 'Isoniemi', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1800 N Main St', 'Wheaton', 'Dupage', 'IL', '60187', '6306656200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295779239', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000520', 'IHP000520', 'ILCHIGSTD', 'Dupage Medical Group', 'Jaime', NULL, 'Villanueva', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 405', 'Winfield', 'Dupage', 'IL', '60190', '6308716699', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295796217', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000047', 'IHP000047', 'ILCHIGSTD', 'Ehv-Edward Medical Group', 'Kinjal', NULL, 'Shah          ', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '130 S Weber Rd  Ste 100', 'Bolingbrook', 'Dupage', 'IL', '60540', '6306465777', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1295937464', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('432036896', 'IHP000737', 'IHP000737', 'ILCHIGSTD', 'Dermatology and Plastic Surgery', 'Kimberly', NULL, 'Bauer                 ', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '1124 Essington Rd ', 'Joliet', 'Will', 'IL', '60435', '8157448554', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1295946473', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363879844', 'IHP000709', 'IHP000709', 'ILCHIGSTD', 'Suburban Gastroenterology', 'Ravi', NULL, 'Nadimpalli', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '1243 Rickert Dr', 'Naperville', 'Dupage', 'IL', '60540', '6305276450', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1306043021', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000470', 'IHP000470', 'ILCHIGSTD', 'Dupage Medical Group', 'Igor', NULL, 'Kosciuch', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '7409 Woodridge Dr Ste Ste F', 'Woodridge', 'Dupage', 'IL', '60517', '6305453535', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306093380', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000447', 'IHP000447', 'ILCHIGSTD', 'Dupage Medical Group', 'Vaishali', NULL, 'Dev', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2155 Citygate Ln Ste Ste 115', 'Naperville', 'Dupage', 'IL', '60563', '6309462100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306123310', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000439', 'IHP000439', 'ILCHIGSTD', 'Dupage Medical Group', 'Erin', NULL, 'Beecher', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '801 N Cass Ave  Ste Ste 100', 'Westmont', 'Dupage', 'IL', '60559', '6309672000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306281662', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000985', 'IHP000985', 'ILCHIGSTD', NULL, 'Zeina', NULL, 'Kalache', 'MD', 'Internal Medicine', 'Pediatrics', NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306812557', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000154', 'IHP000154', 'ILCHIGSTD', 'Dupage Medical Group', 'Zeina', NULL, 'Kalache', 'MD', 'Internal Medicine', 'Pediatrics', NULL, NULL, 'O', '801 N Cass Ave Ste Ste 300', 'Westmont', 'Dupage', 'IL', '60559', '6309634570', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306812557', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000877', 'IHP000877', 'ILCHIGSTD', NULL, 'James', NULL, 'Nikoleit', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306813316', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000194', 'IHP000194', 'ILCHIGSTD', 'Dupage Medical Group', 'James', NULL, 'Nikoleit', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 130', 'Lombard', 'Dupage', 'IL', '60148', '6306274722', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306813316', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000017', 'IHP000017', 'ILCHIGSTD', 'Edward Health Ventures', 'Daniel', NULL, 'Sikic', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '76 W Countryside Pkwy', 'Yorkville', 'Kendall', 'IL', '60560', '6305532722', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1306839055', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000752', 'IHP000752', 'ILCHIGSTD', 'Edward Health Ventures', 'George', 'I', 'Salti', 'MD', 'General Surgery', '', '', NULL, 'O', '120 Spalding Dr  Ste 111', 'Naperville', 'Dupage', 'IL', '60540', '6305273788', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', '', 'HCFA|UB|', '1306847702', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363247842', 'IHP000248', 'IHP000248', 'ILCHIGSTD', 'Ratish Kaura, MD', 'Ratish', NULL, 'Kaura', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '24 W 462 75th St Ste ', 'Naperville', 'Will', 'IL', '60564', '6309612900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1306852033', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000493', 'IHP000493', 'ILCHIGSTD', 'Dupage Medical Group', 'Karen', NULL, 'Ulfers', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1948 three Farms Ave', 'Naperville', 'Dupage', 'IL', '60540', '6305478000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306856380', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364429647', 'IHP000253', 'IHP000253', 'ILCHIGSTD', 'Twenty First Century Pediatrics', 'Susan', NULL, 'Sankari', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '640 S Washington St Ste Ste 224', 'Naperville', 'Dupage', 'IL', '60540', '6307788800', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1306984216', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000579', 'IHP000579', 'ILCHIGSTD', 'Dupage Medical Group', 'Leslie', NULL, 'Spencer', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '908 N Elm St Ste Ste 300', 'Hinsdale', 'Dupage', 'IL', '60521', '6309202229', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316051097', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000949', 'IHP000949', 'ILCHIGSTD', NULL, 'Rita', NULL, 'Herzing', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316103559', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000143', 'IHP000143', 'ILCHIGSTD', 'Dupage Medical Group', 'Rita', NULL, 'Herzing', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1800 N Main St', 'Wheaton', 'Dupage', 'IL', '60187', '6306656200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316103559', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000174', 'IHP000174', 'ILCHIGSTD', 'Dupage Medical Group', 'Patrick', NULL, 'Mackey', 'MD', 'Internal Medicine', 'Pediatrics', NULL, NULL, 'O', '1800 N Main St', 'Wheaton', 'Dupage', 'IL', '60187', '6305106900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316151848', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000471', 'IHP000471', 'ILCHIGSTD', 'Dupage Medical Group', 'Laura', NULL, 'Krause', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '7409 Woodridge Dr Ste Ste F', 'Woodridge', 'Dupage', 'IL', '60517', '6305453535', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316209802', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000512', 'IHP000512', 'ILCHIGSTD', 'Dupage Medical Group', 'Megan', NULL, 'Biederman', 'NP', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 102', 'Naperville', 'Dupage', 'IL', '60540', '6308716699', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316276538', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000983', 'IHP000983', 'ILCHIGSTD', NULL, 'Linda,M', NULL, 'Gruener', 'DO', 'Radiology', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316902919', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000626', 'IHP000626', 'ILCHIGSTD', 'Dupage Medical Group', 'Linda,M', NULL, 'Gruener', 'DO', 'Radiology', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 210', 'Lombard', 'Dupage', 'IL', '60148', '6308738800', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316902919', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000134', 'IHP000134', 'ILCHIGSTD', 'Dupage Medical Group', 'Linda,M', NULL, 'Gruener', 'DO', 'Radiology', NULL, NULL, NULL, 'O', '512 W Burlington Ave Ste Ste 100 ', 'Lagrange', 'Cook', 'IL', '60525', '6305794801', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316902919', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000553', 'IHP000553', 'ILCHIGSTD', 'Dupage Medical Group', 'Jean', NULL, 'Ung', 'MD', 'Urology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 405', 'Winfield', 'Dupage', 'IL', '60190', '6307901221', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1316908312', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000322', 'IHP000322', 'ILCHIGSTD', 'Dupage Medical Group', 'Donald', NULL, 'Hoscheit', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste LL01', 'Winfield', 'Dupage', 'IL', '60190', '6307172600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1316913809', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000012', 'IHP000012', 'ILCHIGSTD', 'Edward Health Ventures', 'Tomas', NULL, 'Jakstys', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '76 W Countryside Pkwy', 'Yorkville', 'Kendall', 'IL', '60560', '6305532722', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1316930068', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('205861109', 'IHP000273', 'IHP000273', 'ILCHIGSTD', 'Fox Valley Radiation Oncology', 'Neil', NULL, 'Dasgupta', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste 111', 'Naperville', 'Dupage', 'IL', '60540', '6305273788', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1316974363', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000807', 'IHP000807', 'ILCHIGSTD', NULL, 'Craig', NULL, 'Anderson', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1326025347', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000092', 'IHP000092', 'ILCHIGSTD', 'Dupage Medical Group', 'Craig', NULL, 'Anderson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '3011 Butterfield Rd Ste Ste 240', 'Oak Brook', 'Dupage', 'IL', '60523', '6306288889', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1326025347', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('261155867', 'IHP000263', 'IHP000263', 'ILCHIGSTD', 'Dupage Medical Group', 'Susan', NULL, ' Felber', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '6733 Kingery Hwy', 'Willowbrook', 'Dupage', 'IL', '60527', '6303254049', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1326096637', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000970', 'IHP000970', 'ILCHIGSTD', NULL, 'Susan', NULL, ' Felber', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1326096637', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000122', 'IHP000122', 'ILCHIGSTD', 'Dupage Medical Group', 'Susan', NULL, ' Felber', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '6733 Kingery Hwy', 'Willowbrook', 'Dupage', 'IL', '60527', '6303254049', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1326096637', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000397', 'IHP000397', 'ILCHIGSTD', 'Dupage Medical Group', 'Samuel', NULL, 'Cordova', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1900 Ogden Ave Ste Ste 210', 'Aurora', 'Dupage', 'IL', '60504', '6303751900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1326137225', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000026', 'IHP000026', 'ILCHIGSTD', 'Ehv-Edward Medical Group', 'Vinayak', NULL, 'Dongre    ', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '16151 Weber Rd  Ste 201', 'Crest Hill', 'Will', 'IL', '60403', '8158382888', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1326193541', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000874', 'IHP000874', 'ILCHIGSTD', NULL, 'Jacques', NULL, 'Jentel', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336115583', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000153', 'IHP000153', 'ILCHIGSTD', 'Dupage Medical Group', 'Jacques', NULL, 'Jentel', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 130', 'Lombard', 'Dupage', 'IL', '60148', '6306274722', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336115583', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000889', 'IHP000889', 'ILCHIGSTD', NULL, 'Jerome', NULL, 'Hong', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336115823', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000144', 'IHP000144', 'ILCHIGSTD', 'Dupage Medical Group', 'Jerome', NULL, 'Hong', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '636 Raymond Dr Ste Ste 301', 'Naperville', 'Dupage', 'IL', '60563', '6309614155', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336115823', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000310', 'IHP000310', 'ILCHIGSTD', 'Dupage Medical Group', 'Chanachai', NULL, 'Memark', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 180', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6304699200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336116771', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000284', 'IHP000284', 'ILCHIGSTD', 'Dupage Medical Group', 'Sonjai', NULL, 'Bhatia', 'MD', 'Cardiology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 300', 'Winfield', 'Dupage', 'IL', '60190', '6309338100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336121037', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000920', 'IHP000920', 'ILCHIGSTD', NULL, 'Margaret', NULL, 'Hannon', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336156751', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000139', 'IHP000139', 'ILCHIGSTD', 'Dupage Medical Group', 'Margaret', NULL, 'Hannon', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '5600 S Wolf Rd Ste Ste 110', 'Western Springs', 'Cook', 'IL', '60558', '7082464155', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336156751', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000437', 'IHP000437', 'ILCHIGSTD', 'Dupage Medical Group', 'Deborah', NULL, 'Andras', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2155 Citygate Ln Ste Ste 115', 'Naperville', 'Dupage', 'IL', '60563', '6309462100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336246743', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364113345', 'IHP000720', 'IHP000720', 'ILCHIGSTD', 'Womens Center For Health', 'Timothy', NULL, 'Vierling', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1220 Hobson Rd Ste Ste 116', 'Naperville', 'Dupage', 'IL', '60540', '6304163300', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336250380', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('581672987', 'IHP000745', 'IHP000745', 'ILCHIGSTD', 'Edward Health Ventures', 'Alyssa', NULL, 'Truong       ', 'PA-C', 'Family Practice', NULL, NULL, NULL, 'O', '20 S Weber Rd ', 'Romeoville', 'Will', 'IL', '60446', '6305273645', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336335934', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000743', 'IHP000743', 'ILCHIGSTD', 'Edward Health Ventures', 'Alyssa', NULL, 'Truong       ', 'PA-C', 'Family Practice', NULL, NULL, NULL, 'O', '430 Warrenville Rd Ste Ste 230', 'Lisle', 'Dupage', 'IL', '60532', '6304326200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336335934', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000411', 'IHP000411', 'ILCHIGSTD', 'Dupage Medical Group', 'Carrie', NULL, 'Smith', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '4115 Fairview Ave', 'Downers Grove', 'Dupage', 'IL', '60515', '6309681881', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336343698', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000120', 'IHP000120', 'ILCHIGSTD', 'Dupage Medical Group', 'Alison', NULL, 'Escalante', 'MD', 'Pediatrics ', NULL, NULL, NULL, 'O', '2940 Rolling Ridge Dr Ste Ste 300', 'Naperville', 'Will', 'IL', '60564', '6306465800', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336367853', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000786', 'IHP000786', 'ILCHIGSTD', 'Edward Medical Group-Ob/Gyn Naperville', 'Robaab', NULL, 'Siddiqui', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 406', 'Naperville', 'Dupage', 'IL', '60540', '6309619485', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336379098', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000837', 'IHP000837', 'ILCHIGSTD', NULL, 'Catherine', NULL, ' Grotelueschen', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346208428', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000135', 'IHP000135', 'ILCHIGSTD', 'Dupage Medical Group', 'Catherine', NULL, ' Grotelueschen', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2340 Highland Ave Ste Ste 210', 'Lombard', 'Dupage', 'IL', '60148', '6309322020', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346208428', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362705494', 'IHP000264', 'IHP000264', 'ILCHIGSTD', 'Dupage Medical Group', 'Catherine', NULL, ' Grotelueschen', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2340 Highland Ave Ste Ste 210', 'Lombard', 'Dupage', 'IL', '60148', '6309322020', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346208428', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000930', 'IHP000930', 'ILCHIGSTD', NULL, 'Michael', NULL, 'Fitzgerald', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346215407', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000124', 'IHP000124', 'ILCHIGSTD', 'Dupage Medical Group', 'Michael', NULL, 'Fitzgerald', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '640 S Washington St Ste Ste 350', 'Naperville', 'Dupage', 'IL', '60540', '6307172646', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346215407', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000569', 'IHP000569', 'ILCHIGSTD', 'Dupage Medical Group', 'Scott', NULL, 'Kagan', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste Ste 309', 'Naperville', 'Dupage', 'IL', '60540', '6305276360', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1346216595', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000958', 'IHP000958', 'ILCHIGSTD', NULL, 'Scott', NULL, 'Murphy', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346217346', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000191', 'IHP000191', 'ILCHIGSTD', 'Dupage Medical Group', 'Scott', NULL, 'Murphy', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 210', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6304697700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346217346', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000531', 'IHP000531', 'ILCHIGSTD', 'Dupage Medical Group', 'Michael', NULL, 'Sams', 'MD', 'Rheumatology', NULL, NULL, NULL, 'O', '636 Raymond Dr Ste Ste 304', 'Naperville', 'Dupage', 'IL', '60563', '6302680200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1346232046', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000932', 'IHP000932', 'ILCHIGSTD', NULL, 'Michael', NULL, 'Popper', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346298684', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000203', 'IHP000203', 'ILCHIGSTD', 'Dupage Medical Group', 'Michael', NULL, 'Popper', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '675 W North Ave Ste Ste 330', 'Melrose Park', 'Mchenry', 'IL', '60180', '7084505060', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346298684', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362705494', 'IHP000267', 'IHP000267', 'ILCHIGSTD', 'Dupage Medical Group', 'Michael', NULL, 'Popper', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '675 W North Ave Ste Ste 330', 'Melrose Park', 'Mchenry', 'IL', '60180', '7084505060', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346298684', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000391', 'IHP000391', 'ILCHIGSTD', 'Dupage Medical Group', 'Stephen', NULL, 'Arndt', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 300', 'Naperville', 'Dupage', 'IL', '60540', '6307901872', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346301322', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000852', 'IHP000852', 'ILCHIGSTD', NULL, 'Donatus', NULL, 'Weithman', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346317385', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000231', 'IHP000231', 'ILCHIGSTD', 'Dupage Medical Group', 'Donatus', NULL, 'Weithman', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1220 Hobson Rd Ste Ste 204', 'Naperville', 'Dupage', 'IL', '60540', '6304167766', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346317385', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000664', 'IHP000664', 'ILCHIGSTD', 'Suburban Lung Associates', 'Amit', NULL, 'Goyal', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1346318813', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000597', 'IHP000597', 'ILCHIGSTD', 'Dupage Medical Group', 'Nazish', NULL, 'Ekram', 'MD', 'Hospitalist', 'Internal Medicine', NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6304699200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1346496965', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000487', 'IHP000487', 'ILCHIGSTD', 'Dupage Medical Group', 'Reny', NULL, 'Samuel', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste L10', 'Lombard', 'Dupage', 'IL', '60148', '6308738860', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346563343', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000780', 'IHP000780', 'ILCHIGSTD', 'Edward Health Ventures-Linden Oaks Medical Group', 'Melissa ', NULL, 'Sautter', 'APN', 'Psychiatry', NULL, NULL, NULL, 'O', '1335 N Mill St Ste 100', 'Naperville', 'Dupage', 'IL', '60563', '6306468000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1346598125', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000912', 'IHP000912', 'ILCHIGSTD', NULL, 'Lenora', NULL, 'Su', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356301170', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000221', 'IHP000221', 'ILCHIGSTD', 'Dupage Medical Group', 'Lenora', NULL, 'Su', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1800 N Main St', 'Wheaton', 'Dupage', 'IL', '60187', '6306656200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356301170', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000793', 'IHP000793', 'ILCHIGSTD', 'Ehv-Edward Neuroscience Institute', 'Kevin', NULL, 'Kelly   ', 'MD', 'NEUROSURGERY', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste 101', 'Naperville', 'Dupage', 'IL', '60540', '6305277730', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1356305882', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000426', 'IHP000426', 'ILCHIGSTD', 'Dupage Medical Group', 'John', NULL, 'Gashkoff', 'MD', 'Pain Management', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste Ste 400', 'Naperville', 'Dupage', 'IL', '60540', '6309676000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1356309694', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000327', 'IHP000327', 'ILCHIGSTD', 'Dupage Medical Group', 'Harold', NULL, 'Mozwecz', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 208', 'Naperville', 'Dupage', 'IL', '60540', '6307172600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1356318349', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364028976', 'IHP000715', 'IHP000715', 'ILCHIGSTD', 'Digestive Health Services', 'Rockford', NULL, 'Yapp', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '3825 Highland Ave Ste Twr 2 #302', 'Downers Grove', 'Dupage', 'IL', '60515', '6304349312', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1356327910', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000764', 'IHP000764', 'ILCHIGSTD', 'Edward Health Ventures-Linden Oaks Medical Group', 'Susan ', NULL, 'Ahmari', 'MD', 'Psychiatry', NULL, NULL, NULL, 'O', '3540 Seven Bridges Dr Ste 230', 'Woodridge', 'Dupage', 'IL', '60517', '6309649400', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1356328058', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000790', 'IHP000790', 'ILCHIGSTD', 'Ehv-Edward Neuroscience Institute', 'Henry', NULL, 'Echiverri ', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '3 S 517 Winfield Rd Ste A', 'Warrenville', 'Dupage', 'IL', '60555', '6308369121', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1356347264', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000573', 'IHP000573', 'ILCHIGSTD', 'Dupage Medical Group', 'Susan', NULL, 'Mitchell', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '3743 Highland Ave Ste Ste 1002', 'Downers Grove', 'Dupage', 'IL', '60515', '6304356107', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356468656', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000348', 'IHP000348', 'ILCHIGSTD', 'Dupage Medical Group', 'Neel', NULL, 'Shah', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '430 Warrenville Rd Ste Ste 300', 'Lisle', 'Dupage', 'IL', '60532', '6303647850', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1356508915', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000544', 'IHP000544', 'ILCHIGSTD', 'Dupage Medical Group', 'Mark', NULL, 'Fisher', 'MD', 'Urology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 405', 'Winfield', 'Dupage', 'IL', '60190', '6307901221', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1356529028', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000673', 'IHP000673', 'ILCHIGSTD', 'Suburban Lung Associates', 'Clifford', NULL, 'Massie', 'MD', 'Sleep Medicine', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1356539621', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000762', 'IHP000762', 'ILCHIGSTD', 'Edward Health Ventures-Edward Neuroscience Naperville', 'Caryn ', NULL, 'Josh', 'APN', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '120 Spalding Dr  Ste 101', 'Naperville', 'Adair', 'IL', '63540', '6305277730', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1356628275', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000413', 'IHP000413', 'ILCHIGSTD', 'Dupage Medical Group', 'Kevin', NULL, 'Walsh', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 300', 'Naperville', 'Dupage', 'IL', '60540', '6303558000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1366403313', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000064', 'IHP000064', 'ILCHIGSTD', 'Edward Health Ventures', 'Colleen', NULL, 'Noonan    ', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '1247 Rickert Dr', 'Naperville', 'Dupage', 'IL', '60540', '6303577979', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1366439234', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000424', 'IHP000424', 'ILCHIGSTD', 'Dupage Medical Group', 'Bryan', NULL, 'Kemker', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 330', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6304699200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1366439390', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363879844', 'IHP000704', 'IHP000704', 'ILCHIGSTD', 'Suburban Gastroenterology', 'Scott', NULL, 'Berger', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '1243 Rickert Dr', 'Naperville', 'Dupage', 'IL', '60540', '6305276450', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1366483455', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362684607', 'IHP000640', 'IHP000640', 'ILCHIGSTD', 'Dupage Urology Associates', 'Bejan', NULL, 'Fakouri', 'MD', 'Urology', NULL, NULL, NULL, 'O', '1259 Rickert Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303691572', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1366490633', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000096', 'IHP000096', 'ILCHIGSTD', 'Dupage Medical Group', 'Anita', NULL, 'Bednarz', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1800 N Main St', 'Wheaton', 'Dupage', 'IL', '60187', '6305106900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1366609323', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000314', 'IHP000314', 'ILCHIGSTD', 'Dupage Medical Group', 'Joseph', NULL, 'Henske', 'MD', 'Endocrinology', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 310', 'Glen Ellyn', 'Dupage', 'IL', '60137', '6307894910', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1366635807', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000294', 'IHP000294', 'ILCHIGSTD', 'Dupage Medical Group', 'George', NULL, 'Nijmeh', 'MD', 'Cardiology', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 400', 'Naperville', 'Dupage', 'IL', '60540', '6307182660', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1366645046', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000791', 'IHP000791', 'ILCHIGSTD', 'Ehv-Edward Neuroscience Institute', 'Hurmina', NULL, 'Muqtadar                    ', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '3 S 517 Winfield Rd', 'Warrenville', 'Dupage', 'IL', '60555', '6308369121', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1366647232', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000422', 'IHP000422', 'ILCHIGSTD', 'Dupage Medical Group', 'Feodor', NULL, 'Ung', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 220', 'Lombard', 'Dupage', 'IL', '60148', '6308738700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376503987', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000567', 'IHP000567', 'ILCHIGSTD', 'Dupage Medical Group', 'Stuart', NULL, 'Heimburger', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '231 S Gary Ave Ste Ste 114', 'Bloomingdale', 'Dupage', 'IL', '60108', '6308938585', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376519132', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000866', 'IHP000866', 'ILCHIGSTD', NULL, 'Gigi', NULL, 'Ip', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376519777', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000151', 'IHP000151', 'ILCHIGSTD', 'Dupage Medical Group', 'Gigi', NULL, 'Ip', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3743 Highland Ave Ste Ste 1001', 'Downers Grove', 'Dupage', 'IL', '60515', '6304359888', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376519777', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000386', 'IHP000386', 'ILCHIGSTD', 'Dupage Medical Group', 'Matthew', NULL, 'Bueche', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1259 Rickert Dr Ste Ste 101', 'Naperville', 'Dupage', 'IL', '60540', '6303551300', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376539163', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000484', 'IHP000484', 'ILCHIGSTD', 'Dupage Medical Group', 'Kristen', NULL, 'Restaino', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste L10', 'Lombard', 'Dupage', 'IL', '60148', '6308738860', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376561118', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000864', 'IHP000864', 'ILCHIGSTD', NULL, 'Gail', NULL, 'Bertoni', 'NP', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376564724', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000240', 'IHP000240', 'ILCHIGSTD', 'Dupage Medical Group', 'Gail', NULL, 'Bertoni', 'NP', 'Family Practice', NULL, NULL, NULL, 'O', '2050 S Finley Rd Ste Ste 50', 'Lombard', 'Dupage', 'IL', '60148', '6308738875', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376564724', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000417', 'IHP000417', 'ILCHIGSTD', 'Dupage Medical Group', 'Andrew', NULL, 'Celmer', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '808 Rickert Dr Ste Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376571604', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000475', 'IHP000475', 'ILCHIGSTD', 'Dupage Medical Group', 'Elizabeth', NULL, 'Mootheril', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste L10', 'Lombard', 'Dupage', 'IL', '60148', '6308738860', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376576223', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000942', 'IHP000942', 'ILCHIGSTD', NULL, 'Paulette', NULL, 'Feiereisel', 'NP', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376610477', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000241', 'IHP000241', 'ILCHIGSTD', 'Dupage Medical Group', 'Paulette', NULL, 'Feiereisel', 'NP', 'Family Practice', NULL, NULL, NULL, 'O', '675 W North Ave Ste Ste 233', 'Melrose Park', 'Cook', 'IL', '60160', '7084505060', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376610477', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000744', 'IHP000744', 'ILCHIGSTD', 'Edward Health Ventures', 'Timothy', NULL, 'Collins   ', 'APN', 'Family Practice', NULL, NULL, NULL, 'O', '16519 S Route 59', 'Plainfield', 'Will', 'IL', '60586', '6306465020', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376644435', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000031', 'IHP000031', 'ILCHIGSTD', 'Edward Health Ventures', 'Gregory', NULL, 'Goska      ', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '130 N Weber Rd  Ste 100', 'Bolingbrook', 'Will', 'IL', '60440', '6306465777', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376790071', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000337', 'IHP000337', 'ILCHIGSTD', 'Dupage Medical Group', 'Bart', NULL, 'Green', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste Ste 100', 'Naperville', 'Dupage', 'IL', '60540', '6307901700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1386610087', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000361', 'IHP000361', 'ILCHIGSTD', 'Dupage Medical Group', 'Kerry', NULL, 'Disanto', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '908 N Elm St Ste Ste 110', 'Hinsdale', 'Dupage', 'IL', '60521', '6309868770', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386640878', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000908', 'IHP000908', 'ILCHIGSTD', NULL, 'Kimberly', NULL, ' Bennett', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386708493', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000098', 'IHP000098', 'ILCHIGSTD', 'Dupage Medical Group', 'Kimberly', NULL, ' Bennett', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1220 Hobson Rd Ste Ste 204', 'Naperville', 'Dupage', 'IL', '60540', '6304167766', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386708493', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000373', 'IHP000373', 'ILCHIGSTD', 'Dupage Medical Group', 'Renee', NULL, 'Corner', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '300 S County Farm Rd Ste Ste A', 'Wheaton', 'Dupage', 'IL', '60187', '6305478045', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386715100', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000428', 'IHP000428', 'ILCHIGSTD', 'Dupage Medical Group', 'Kathleen', NULL, 'Rogowski', 'PA-C', 'Pain Management', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste Ste 400', 'Naperville', 'Dupage', 'IL', '60540', '6309676000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1386718278', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363862327', 'IHP000695', 'IHP000695', 'ILCHIGSTD', 'Midwest Ent Consultants, Ltd', 'Kelly', NULL, 'Owens', 'PA', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '1247 Rickert Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6304202323', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386768992', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000046', 'IHP000046', 'ILCHIGSTD', 'Edward Health Ventures-Edward Medical Group', 'Adam ', NULL, 'Schriedel', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '120 Spalding Dr  Ste 310', 'Naperville', 'Dupage', 'IL', '60540', '6305275000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1386815504', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000960', 'IHP000960', 'ILCHIGSTD', NULL, 'Sheetal', NULL, 'Rao', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386840148', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000206', 'IHP000206', 'ILCHIGSTD', 'Dupage Medical Group', 'Sheetal', NULL, 'Rao', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3743 Highland Ave Ste Ste 1001', 'Downers Grove', 'Dupage', 'IL', '60515', '6304359888', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386840148', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000602', 'IHP000602', 'ILCHIGSTD', 'Dupage Medical Group', 'Kelly', NULL, 'Mackie', 'DO', 'Hospitalist', 'Internal Medicine', NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6304699200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1386871259', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000754', 'IHP000754', 'ILCHIGSTD', 'Edward Health Ventures', 'Dan R. ', NULL, 'Sears     ', 'PA-C', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste 101', 'Naperville', 'Dupage', 'IL', '60540', '6305277730', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1386989564', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000789', 'IHP000789', 'ILCHIGSTD', 'Ehv-Edward Neuroscience Institute', 'Diane ', NULL, 'Blowers      ', 'APN', 'Neurology', NULL, NULL, NULL, 'O', '3 S 517 Winfield Rd Ste A', 'Warrenville', 'Dupage', 'IL', '60555', '6308369121', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1396077970', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000881', 'IHP000881', 'ILCHIGSTD', NULL, 'Jason', NULL, ' Dy', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396710265', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000118', 'IHP000118', 'ILCHIGSTD', 'Dupage Medical Group', 'Jason', NULL, ' Dy', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2940 Rolling Ridge Dr Ste Ste 300', 'Naperville', 'Dupage', 'IL', '60565', '6306465800', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396710265', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000903', 'IHP000903', 'ILCHIGSTD', NULL, 'Kathleen', NULL, 'Gruzalski', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396710356', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000136', 'IHP000136', 'ILCHIGSTD', 'Dupage Medical Group', 'Kathleen', NULL, 'Gruzalski', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '3743 Highland Ave Ste Ste 1003', 'Downers Grove', 'Dupage', 'IL', '60515', '6309646049', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396710356', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000944', 'IHP000944', 'ILCHIGSTD', NULL, 'Raulie ', NULL, 'Lo', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396712220', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000172', 'IHP000172', 'ILCHIGSTD', 'Dupage Medical Group', 'Raulie ', NULL, 'Lo', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2940 Rolling Ridge Dr Ste Ste 300', 'Naperville', 'Will', 'IL', '60564', '6306465800', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396712220', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000190', 'IHP000190', 'ILCHIGSTD', 'Dupage Medical Group', 'Patricia', NULL, 'Murphy', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '1020 E Ogden Ave Ste Ste 201', 'Naperville', 'Dupage', 'IL', '60563', '6303694550', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396712741', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000940', 'IHP000940', 'ILCHIGSTD', NULL, 'Patricia', NULL, 'Murphy', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396712741', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000854', 'IHP000854', 'ILCHIGSTD', NULL, 'Edward', NULL, 'Pont', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396713145', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000202', 'IHP000202', 'ILCHIGSTD', 'Dupage Medical Group', 'Edward', NULL, 'Pont', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '152 N Addison Rd Ste Ste 200', 'Elmhurst', 'Dupage', 'IL', '60126', '6308323100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396713145', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000850', 'IHP000850', 'ILCHIGSTD', NULL, 'Don', NULL, 'Seidman', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396713970', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000214', 'IHP000214', 'ILCHIGSTD', 'Dupage Medical Group', 'Don', NULL, 'Seidman', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '152 N Addison Rd Ste Ste 200', 'Elmhurst', 'Dupage', 'IL', '60126', '6308323100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396713970', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000792', 'IHP000792', 'ILCHIGSTD', 'Ehv-Edward Neuroscience Institute', 'Mohammad', NULL, 'Sajed', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '120 Spalding Dr  Ste 101', 'Naperville', 'Dupage', 'IL', '60540', '6305277730', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1396785127', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363661992', 'IHP000683', 'IHP000683', 'ILCHIGSTD', 'Western Dupage Obstetrics and  Gynecology', 'George', NULL, 'Banuelos', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '3800 S Highland Ave Ste Ste 204', 'Downers Grove', 'Dupage', 'IL', '60515', '6308100777', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1396815601', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363862327', 'IHP000691', 'IHP000691', 'ILCHIGSTD', 'Midwest Ent Consultants, Ltd', 'Andrea', NULL, 'Shogan', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '1247 Rickert Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6304202323', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1396902490', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000613', 'IHP000613', 'ILCHIGSTD', 'Dupage Medical Group', 'Andrea', NULL, 'Keeling', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '430 Warrenville Rd Ste Ste 230', 'Lisle', 'Dupage', 'IL', '60532', '6304326200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396961017', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000795', 'IHP000795', 'ILCHIGSTD', 'Ehv-Edward Neuroscience Institute', 'Caryn', NULL, 'Josh                          ', 'NP', 'Neurology', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste 101', 'Naperville', 'Dupage', 'IL', '60540', '6305277730', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1396976445', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000469', 'IHP000469', 'ILCHIGSTD', 'Dupage Medical Group', 'Swapna', NULL, 'Kolipaka', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 240', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6305457801', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396981320', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000872', 'IHP000872', 'ILCHIGSTD', NULL, 'Guarav', NULL, 'Vajaria', 'MD', 'Podiatry', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396986154', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000227', 'IHP000227', 'ILCHIGSTD', 'Dupage Medical Group', 'Guarav', NULL, 'Vajaria', 'MD', 'Podiatry', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 210', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6304697700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396986154', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000797', 'IHP000797', 'ILCHIGSTD', 'Ehv-Edward Neuroscience Institute', 'Michael', NULL, 'Hurley', 'MD', 'Radiology', NULL, NULL, NULL, 'O', '120 Spalding Dr  Ste 101', 'Naperville', 'Dupage', 'IL', '60540', '6305277730', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1407099872', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000547', 'IHP000547', 'ILCHIGSTD', 'Dupage Medical Group', 'Joan', NULL, 'Matthews', 'PA-C', 'Urology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 405', 'Winfield', 'Dupage', 'IL', '60190', '6307901221', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1407196561', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000349', 'IHP000349', 'ILCHIGSTD', 'Dupage Medical Group', 'Nasir', NULL, 'Shahab', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '430 Warrenville Rd Ste Ste 300', 'Lisle', 'Dupage', 'IL', '60532', '6303647850', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1407801061', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000308', 'IHP000308', 'ILCHIGSTD', 'Dupage Medical Group', 'James', NULL, 'Herrmann', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '199 Town Square Ste Ste A', 'Wheaton', 'Dupage', 'IL', '60187', '6308716690', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1407822216', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000971', 'IHP000971', 'ILCHIGSTD', NULL, 'Susan', NULL, 'Kim', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1407822349', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000159', 'IHP000159', 'ILCHIGSTD', 'Dupage Medical Group', 'Susan', NULL, 'Kim', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '636 Raymond Dr Ste Ste 301', 'Naperville', 'Dupage', 'IL', '60563', '6309614155', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1407822349', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000808', 'IHP000808', 'ILCHIGSTD', NULL, 'James', NULL, 'Scruggs', 'MD', 'Geriatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1407824089', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000343', 'IHP000343', 'ILCHIGSTD', 'Dupage Medical Group', 'James', NULL, 'Scruggs', 'MD', 'Geriatrics', NULL, NULL, NULL, 'O', '1800 N Main St', 'Wheaton', 'Dupage', 'IL', '60187', '6306656200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1407824089', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000895', 'IHP000895', 'ILCHIGSTD', NULL, 'Joseph', NULL, 'Russell', 'DO', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1407824980', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000085', 'IHP000085', 'ILCHIGSTD', 'Dupage Medical Group', 'Joseph', NULL, 'Russell', 'DO', 'Pediatrics', NULL, NULL, NULL, 'O', '14710 S Naperville Rd Ste Ste 110', 'Plainfield,', 'Will', 'IL', '60544', '8156762580', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1407824980', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('363378337', 'IHP000669', 'IHP000669', 'ILCHIGSTD', 'Suburban Lung Associates', 'George', NULL, 'Cromydas', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1407830169', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363653432', 'IHP000681', 'IHP000681', 'ILCHIGSTD', 'Midwest Cardiac Consultants', 'Rabindra', NULL, 'Malhotra', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '4121 Fairview Ave Ste 103B', 'Downers Grove', 'Dupage', 'IL', '60515', '6308520230', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1407838204', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000513', 'IHP000513', 'ILCHIGSTD', 'Dupage Medical Group', 'Kristina', NULL, 'Cipparrone', 'NP', 'Pulmonary', NULL, NULL, NULL, 'O', '3825 Highland Ave Ste Ste 310', 'Downers Grove', 'Dupage', 'IL', '60515', '6308716699', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1407889447', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('262403738', 'IHP000066', 'IHP000066', 'ILCHIGSTD', 'All About Kids Pediatrics SC', 'Colette', NULL, 'Fisher', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '1250 North Mill St Ste Ste 100', 'Naperville', 'Dupage', 'IL', '60563', '6303556996', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1417018649', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000603', 'IHP000603', 'ILCHIGSTD', 'Dupage Medical Group', 'Anjali', NULL, 'Marwaha', 'MD', 'Hospitalist', 'Internal Medicine', NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6304699200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1417158098', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000015', 'IHP000015', 'ILCHIGSTD', 'Ehv-Edward Medical Group', 'Tamar', NULL, 'Marcotte  ', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '16519 S Route 59', 'Plainfield', 'Will', 'IL', '60586', '6306465020', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1417185117', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000756', 'IHP000756', 'ILCHIGSTD', 'Edward Health Ventures', 'Cheryl', NULL, 'Lorenzin     ', 'APN', 'Neurology', NULL, NULL, NULL, 'O', '120 Spalding Dr  Ste 101', 'Naperville ', 'Dupage', 'IL', '60540', '6305277730', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417226986', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000237', 'IHP000237', 'ILCHIGSTD', 'Dupage Medical Group', 'Peter', NULL, 'Yoon', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2340 Highland Ave Ste Ste 210', 'Lombard', 'Dupage', 'IL', '60148', '6309322020', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417905944', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362705494', 'IHP000269', 'IHP000269', 'ILCHIGSTD', 'Dupage Medical Group', 'Peter', NULL, 'Yoon', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2340 Highland Ave Ste Ste 210', 'Lombard', 'Dupage', 'IL', '60148', '6309322020', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417905944', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000365', 'IHP000365', 'ILCHIGSTD', 'Dupage Medical Group', 'Alan', NULL, 'Summers', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 405', 'Winfield', 'Dupage', 'IL', '60190', '6307847700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1417918624', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('421582199', 'IHP000735', 'IHP000735', 'ILCHIGSTD', 'Dupage Plastic Surgery Ltd', 'William', NULL, 'Bull', 'MD', 'Plastic Surgery', NULL, NULL, NULL, 'O', '1307 Macom Dr', 'Naperville', 'Will', 'IL', '60564', '6307176000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1417956947', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000335', 'IHP000335', 'ILCHIGSTD', 'Dupage Medical Group', 'Daniel', NULL, 'Douglas', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '908 N Elm St Ste Ste 310', 'Hinsdale', 'Dupage', 'IL', '60521', '6307901700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417959180', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000431', 'IHP000431', 'ILCHIGSTD', 'Dupage Medical Group', 'Lise', NULL, 'Guay-Bhatia', 'MD', 'Pediatric Ophthalmology', NULL, NULL, NULL, 'O', '1327 Butterfield Rd Ste Ste 618', 'Downers Grove', 'Dupage', 'IL', '60515', '6303228300', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417993197', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000377', 'IHP000377', 'ILCHIGSTD', 'Dupage Medical Group', 'Keri', NULL, 'Warehime', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste L10', 'Lombard', 'Dupage', 'IL', '60148', '6308738860', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427001957', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000655', 'IHP000655', 'ILCHIGSTD', 'Suburban Lung Associates', 'Sara', NULL, 'Greenhill', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1427016948', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000976', 'IHP000976', 'ILCHIGSTD', NULL, 'Thomas', NULL, 'Leib', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427024314', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000171', 'IHP000171', 'ILCHIGSTD', 'Dupage Medical Group', 'Thomas', NULL, 'Leib', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 210', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6304697700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427024314', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000898', 'IHP000898', 'ILCHIGSTD', NULL, 'Judith', NULL, 'Sherman', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427026178', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000216', 'IHP000216', 'ILCHIGSTD', 'Dupage Medical Group', 'Judith', NULL, 'Sherman', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '3011 Butterfield Rd Ste Ste 240', 'Oak Brook', 'Dupage', 'IL', '60523', '6306288889', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427026178', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('205861109', 'IHP000275', 'IHP000275', 'ILCHIGSTD', 'Fox Valley Radiation Oncology', 'Vasudha', NULL, 'Lingareddy', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste 111', 'Naperville', 'Dupage', 'IL', '60540', '6305273788', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1427083393', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000619', 'IHP000619', 'ILCHIGSTD', 'Dupage Medical Group', 'Carol', NULL, 'Chamblin', 'CCNS', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '3755 E Main St Ste Ste 190', 'St. Charles', 'Kane', 'IL', '60174', '6303483100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427137769', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000557', 'IHP000557', 'ILCHIGSTD', 'Dupage Medical Group', 'Katherine', NULL, 'Virnig', 'PA-C', 'Vascular Surgery', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 220', 'Lombard', 'Dupage', 'IL', '60148', '6305457565', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1427334473', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000800', 'IHP000800', 'ILCHIGSTD', 'Ehv-Hematology Oncology Group', 'Jill', NULL, 'Wozny  ', 'APN', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste 111', 'Naperville', 'Dupage', 'IL', '60540', '6305273788', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1427351451', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000482', 'IHP000482', 'ILCHIGSTD', 'Dupage Medical Group', 'Jolly', NULL, 'Patel', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1948 three Farms Ave', 'Naperville', 'Dupage', 'IL', '60540', '6309672000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427480086', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000677', 'IHP000677', 'ILCHIGSTD', 'Suburban Lung Associates', 'Kuljeet', NULL, 'Gill', 'MD', 'SLEEP MEDICINE', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste 204', 'Winfield', 'Dupage', 'IL', '60190', '6306904993', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437101094', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000627', 'IHP000627', 'ILCHIGSTD', 'Dupage Medical Group', 'Yazan', '', 'Kaakaji', 'MD', 'Radiology', '', '', NULL, 'O', '40 S Clay St Ste Ste LL10', 'Hinsdale', 'Dupage', 'IL', '60521', '6304326848', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, '', '', '', '', 'HCFA|UB|', '1437106929', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000056', 'IHP000056', 'ILCHIGSTD', 'Edward Health Ventures', 'Julie', NULL, 'Kauling  ', 'NP', 'Family Practice', NULL, NULL, NULL, 'O', '2007 95th St ', 'Naperville', 'Dupage', 'IL', '60540', '6306466920', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437108909', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364121495', 'IHP000723', 'IHP000723', 'ILCHIGSTD', 'Grossweiner and Blaszak, P.C.', 'James', NULL, 'Grossweiner', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste 405', 'Naperville', 'Dupage', 'IL', '60540', '6303556660', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437114907', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000546', 'IHP000546', 'ILCHIGSTD', 'Dupage Medical Group', 'Ernst', NULL, 'Lisek', 'MD', 'Urology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 405', 'Winfield', 'Dupage', 'IL', '60190', '6307901221', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437126315', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000318', 'IHP000318', 'ILCHIGSTD', 'Dupage Medical Group', 'Rafi', NULL, 'Ali', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 208', 'Naperville', 'Dupage', 'IL', '60540', '6307172600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437136454', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000346', 'IHP000346', 'ILCHIGSTD', 'Dupage Medical Group', 'Daniel', NULL, 'Frank', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '430 Warrenville Rd Ste Ste 300', 'Lisle', 'Dupage', 'IL', '60532', '6303647850', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437194610', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000927', 'IHP000927', 'ILCHIGSTD', NULL, 'Mary', NULL, 'Kungl', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437215076', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000164', 'IHP000164', 'ILCHIGSTD', 'Dupage Medical Group', 'Mary', NULL, 'Kungl', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 310', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6307901792', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437215076', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000926', 'IHP000926', 'ILCHIGSTD', NULL, 'Mary', NULL, 'Barton', 'NP', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437226594', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000238', 'IHP000238', 'ILCHIGSTD', 'Dupage Medical Group', 'Mary', NULL, 'Barton', 'NP', 'Family Practice', NULL, NULL, NULL, 'O', '2340 Highland Ave Ste Ste 210', 'Lombard', 'Dupage', 'IL', '60148', '6309322020', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437226594', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362705494', 'IHP000270', 'IHP000270', 'ILCHIGSTD', 'Dupage Medical Group', 'Mary', NULL, 'Barton', 'NP', 'Family Practice', NULL, NULL, NULL, 'O', '2340 Highland Ave Ste Ste 210', 'Lombard', 'Dupage', 'IL', '60148', '6309322020', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437226594', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000805', 'IHP000805', 'ILCHIGSTD', NULL, 'Aubrey', NULL, 'Grabow', 'PA', 'Physician Assistant', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437260064', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000243', 'IHP000243', 'ILCHIGSTD', 'Dupage Medical Group', 'Aubrey', NULL, 'Grabow', 'PA', 'Physician Assistant', NULL, NULL, NULL, 'O', '2940 Rollingridge Road Ste Ste 300', 'Naperville', 'Will', 'IL', '60564', '6306465800', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437260064', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('432036896', 'IHP000736', 'IHP000736', 'ILCHIGSTD', 'Dermatology and Plastic Surgery', 'Paula', NULL, 'Lapinski', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '1124 Essington Rd ', 'Joliet', 'Will', 'IL', '60435', '8157448554', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437262482', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000550', 'IHP000550', 'ILCHIGSTD', 'Dupage Medical Group', 'Amit', NULL, 'Patel', 'MD', 'Urology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 405', 'Winfield', 'Dupage', 'IL', '60190', '6307901221', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437324084', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000228', 'IHP000228', 'ILCHIGSTD', 'Dupage Medical Group', 'Kenneth', NULL, 'Vercelli', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1020 E Ogden Ave Ste Ste 115', 'Naperville', 'Dupage', 'IL', '60563', '6307178707', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1447210075', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000906', 'IHP000906', 'ILCHIGSTD', NULL, 'Kenneth', NULL, 'Vercelli', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1447210075', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000629', 'IHP000629', 'ILCHIGSTD', 'Dupage Medical Group', 'Sabira,', NULL, 'Khalil', 'MD', 'Radiology', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 210', 'Lombard', 'Dupage', 'IL', '60148', '6308738800', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1447226501', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000504', 'IHP000504', 'ILCHIGSTD', 'Dupage Medical Group', 'Steven', NULL, 'Sigalove', 'MD', 'Plastic Surgery', NULL, NULL, NULL, 'O', '636 Raymond Dr Ste Ste 301', 'Naperville', 'Dupage', 'IL', '60563', '6305457875', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1447228754', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000018', 'IHP000018', 'ILCHIGSTD', 'Edward Health Ventures', 'Maria', NULL, 'Sutkus', 'DO', 'Internal Medicine', 'Pediatrics', NULL, NULL, 'O', '1 E County Line Rd', 'Sandwich', 'Dekalb', 'IL', '60548', '8157862722', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1447243100', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000038', 'IHP000038', 'ILCHIGSTD', 'Edward Health Ventures', 'James', NULL, 'Lengemann', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste 310', 'Naperville', 'Dupage', 'IL', '60540', '6305275000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1447247572', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000390', 'IHP000390', 'ILCHIGSTD', 'Dupage Medical Group', 'Raghu', NULL, 'Pulluru', 'MD', 'Orthopedic Surgery', 'Sports Medicine', NULL, NULL, 'O', '24600 W 127th St Ste Ste 225', 'Plainfield', 'Will', 'IL', '60585', '6307901872', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1447269915', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000453', 'IHP000453', 'ILCHIGSTD', 'Dupage Medical Group', 'Natalie', NULL, 'Glynn', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1948 three Farms Ave', 'Naperville', 'Dupage', 'IL', '60540', '6305478000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1447409545', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000054', 'IHP000054', 'ILCHIGSTD', 'Edward Health Ventures-Edward Medical Group ', 'Constantine ', NULL, 'Wonais', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2255 Monarch Dr', 'Naperville', 'Dupage', 'IL', '60563', '6303001125', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1457340267', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000587', 'IHP000587', 'ILCHIGSTD', 'Dupage Medical Group', 'Donald', NULL, 'Taylor', 'DO', 'Maternal Fetal Medicine', NULL, NULL, NULL, 'O', '3743 Highland Ave Ste Ste 1002', 'Downers Grove', 'Dupage', 'IL', '60515', '6304356107', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1457394520', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000610', 'IHP000610', 'ILCHIGSTD', 'Dupage Medical Group', 'Alan,E', NULL, 'Wurzelbacher', 'MD', 'Hospitalist', 'Internal Medicine', NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6308716699', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1457573347', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000239', 'IHP000239', 'ILCHIGSTD', 'Dupage Medical Group', 'Angelica', NULL, 'Bellisario', 'NP', 'Internal Medicine', NULL, NULL, NULL, 'O', '30 Stratford Dr', 'Bloomingdale', 'Dupage', 'IL', '60108', '6308932210', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457695272', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000975', 'IHP000975', 'ILCHIGSTD', NULL, 'Thomas', NULL, 'Gallagher', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467427641', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000129', 'IHP000129', 'ILCHIGSTD', 'Dupage Medical Group', 'Thomas', NULL, 'Gallagher', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '908 N Elm St Ste Ste 301', 'Hinsdale', 'Dupage', 'IL', '60521', '6303233540', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467427641', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000401', 'IHP000401', 'ILCHIGSTD', 'Dupage Medical Group', 'John', NULL, 'Lombardi', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 300', 'Naperville', 'Dupage', 'IL', '60540', '6307901782', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467455139', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000434', 'IHP000434', 'ILCHIGSTD', 'Dupage Medical Group', 'Barbara', NULL, 'Heller', 'DO', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 220', 'Lombard', 'Dupage', 'IL', '60148', '6305478005', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1467487546', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000037', 'IHP000037', 'ILCHIGSTD', 'Edward Health Ventures', 'Melissa', NULL, 'Kwak', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '76 W Countryside Pkwy', 'Yorkville', 'Kendall', 'IL', '60560', '6305532722', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1467668111', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000472', 'IHP000472', 'ILCHIGSTD', 'Dupage Medical Group', 'Julie', NULL, 'Kupisch', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 240', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6305457801', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467701011', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000878', 'IHP000878', 'ILCHIGSTD', NULL, 'James', NULL, 'Pitrak', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477501369', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000200', 'IHP000200', 'ILCHIGSTD', 'Dupage Medical Group', 'James', NULL, 'Pitrak', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3743 Highland Ave Ste Ste 1001', 'Downers Grove', 'Dupage', 'IL', '60515', '6304359888', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477501369', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('262789320', 'IHP000277', 'IHP000277', 'ILCHIGSTD', 'Suburban Lung Associates', 'Oksana', NULL, 'Shulzhenko', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '630355', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477512838', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000888', 'IHP000888', 'ILCHIGSTD', NULL, 'Jenny', NULL, 'Tan', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477513208', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000222', 'IHP000222', 'ILCHIGSTD', 'Dupage Medical Group', 'Jenny', NULL, 'Tan', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '3755 E Main St Ste Ste 190', 'St. Charles', 'Kane', 'IL', '60174', '6303483100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477513208', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000628', 'IHP000628', 'ILCHIGSTD', 'Dupage Medical Group', 'Kyle,C', NULL, 'Kallenbach', 'MD', 'Radiology', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 210', 'Lombard', 'Dupage', 'IL', '60148', '6308738800', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477529626', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363653432', 'IHP000680', 'IHP000680', 'ILCHIGSTD', 'Midwest Cardiac Consultants', 'Sunil', NULL, 'Lulla', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '4121 Fairview Ave Ste 103B', 'Downers Grove', 'Dupage', 'IL', '60515', '6308520230', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477535201', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000832', 'IHP000832', 'ILCHIGSTD', NULL, 'Beth', NULL, 'Winkler', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477620417', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000233', 'IHP000233', 'ILCHIGSTD', 'Dupage Medical Group', 'Beth', NULL, 'Winkler', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1220 Hobson Rd Ste Ste 204', 'Naperville', 'Dupage', 'IL', '60540', '6304167766', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477620417', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363082580', 'IHP000649', 'IHP000649', 'ILCHIGSTD', 'Hematology-Oncology Consultants', 'Dennis', NULL, 'Azuma', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '100 Spalding Dr  Ste 110', 'Naperville', 'Dupage', 'IL', '60540', '6303691501', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477658862', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000333', 'IHP000333', 'ILCHIGSTD', 'Dupage Medical Group', 'Sandeep', NULL, 'Devata', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '908 N Elm St Ste Ste 310', 'Hinsdale', 'Dupage', 'IL', '60521', '6307901700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477751352', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000766', 'IHP000766', 'ILCHIGSTD', 'Edward Health Ventures-Linden Oaks Medical Group', 'Bradley ', NULL, 'Cutler', 'MD', 'Psychiatry', NULL, NULL, NULL, 'O', '1335 N Mill St Ste 100', 'Naperville', 'Dupage', 'IL', '60563', '6306468000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477781649', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000592', 'IHP000592', 'ILCHIGSTD', 'Dupage Medical Group', 'Fawaz', NULL, 'Ahmad', 'MD', 'Hospitalist', 'Internal Medicine', NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6304699200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477786598', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000783', 'IHP000783', 'ILCHIGSTD', 'Edward Medical Group-General Surgery', 'Peter', NULL, 'Petratos', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '10 W Martin Ave  Ste 225', 'Naperville', 'Dupage', 'IL', '60540', '6303555633', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487612297', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000387', 'IHP000387', 'ILCHIGSTD', 'Dupage Medical Group', 'Nicholas', NULL, 'Mataragas', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste Ste 400', 'Naperville', 'Dupage', 'IL', '60540', '6309672225', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487621009', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000839', 'IHP000839', 'ILCHIGSTD', NULL, 'Christine', NULL, 'Rejdukowski', 'DO', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1487622411', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000082', 'IHP000082', 'ILCHIGSTD', 'Dupage Medical Group', 'Christine', NULL, 'Rejdukowski', 'DO', 'Pediatrics', NULL, NULL, NULL, 'O', '3755 E Main St Ste Ste 190', 'St. Charles', 'Kane', 'IL', '60174', '6303483100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1487622411', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000360', 'IHP000360', 'ILCHIGSTD', 'Dupage Medical Group', 'Grace', NULL, 'Cheng', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '636 Raymond Dr Ste Ste 304', 'Naperville', 'Dupage', 'IL', '60563', '6309614150', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, ' ', NULL, NULL, NULL, 'HCFA|UB|', '1487629572', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000004', 'IHP000004', 'ILCHIGSTD', 'Edward Health Ventures', 'Michelle', NULL, 'Horvath      ', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '16151 Weber Rd ', 'Crest Hill', 'Will', 'IL', '60403', '8158382888', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487643003', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000843', 'IHP000843', 'ILCHIGSTD', NULL, 'Daniel', NULL, 'Grzegorek', 'DO', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1487651337', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000077', 'IHP000077', 'ILCHIGSTD', 'Dupage Medical Group', 'Daniel', NULL, 'Grzegorek', 'DO', 'Internal Medicine', NULL, NULL, NULL, 'O', '6733 Kingery Hwy', 'Willowbrook', 'Dupage', 'IL', '60527', '6303254049', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1487651337', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000289', 'IHP000289', 'ILCHIGSTD', 'Dupage Medical Group', 'Eugene', NULL, 'Greenstein', 'MD', 'Cardiology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 300', 'Winfield', 'Dupage', 'IL', '60190', '6309338100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487666087', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000604', 'IHP000604', 'ILCHIGSTD', 'Dupage Medical Group', 'Leslie', NULL, 'Mattson', 'MD', 'Hospitalist', 'Internal Medicine', NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6304699200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487975181', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363610208', 'IHP000249', 'IHP000249', 'ILCHIGSTD', 'Robert Millar, MD', 'Robert', NULL, 'Millar', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1315 Macom Dr Ste Ste 203', 'Naperville', 'Will', 'IL', '60564', '6308984822', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1497703573', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000623', 'IHP000623', 'ILCHIGSTD', 'Dupage Medical Group', 'Dawn', NULL, 'Kroencke', 'PhD', 'Psychology', NULL, NULL, NULL, 'O', '1800 N Main St', 'Wheaton', 'Dupage', 'IL', '60187', '6306274722', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1497731962', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000436', 'IHP000436', 'ILCHIGSTD', 'Dupage Medical Group', 'Riaz', NULL, 'Ali', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 240', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6305457801', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1497834055', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363556513', 'IHP000679', 'IHP000679', 'ILCHIGSTD', 'Hassan Moghadam, MD', 'Hassan', NULL, 'Moghadam', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste 407', 'Naperville', 'Dupage', 'IL', '60540', '6303574260', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', 'Edward Hospital', NULL, NULL, 'HCFA|UB|', '1497850010', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('336827628', 'IHP000070', 'IHP000070', 'ILCHIGSTD', 'Seema Gupta, MD', 'Seema', NULL, 'Gupta', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '640 S Washington St Ste Ste 280', 'Naperville', 'Dupage', 'IL', '60540', '6307789362', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1497861470', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363862327', 'IHP000692', 'IHP000692', 'ILCHIGSTD', 'Midwest Ent Consultants, Ltd', 'Kelly', NULL, 'Bramlette', 'PA', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '1247 Rickert Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6304202323', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1497910814', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000458', 'IHP000458', 'ILCHIGSTD', 'Dupage Medical Group', 'Amanda', NULL, 'Harms', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2155 Citygate Ln Ste Ste 115', 'Naperville', 'Dupage', 'IL', '60563', '6309462100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508115312', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000588', 'IHP000588', 'ILCHIGSTD', 'Dupage Medical Group', 'Spring', NULL, 'Piatek', 'APN', 'Family Practice', NULL, NULL, NULL, 'O', '430 Warrenville Rd Ste Ste  310', 'Lisle', 'Dupage', 'IL', '60532', '6307901700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508294547', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000838', 'IHP000838', 'ILCHIGSTD', NULL, 'Christine', NULL, 'Ibrahim', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508832775', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000150', 'IHP000150', 'ILCHIGSTD', 'Dupage Medical Group', 'Christine', NULL, 'Ibrahim', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '152 N Addison Rd Ste Ste 200', 'Elmhurst', 'Dupage', 'IL', '60126', '6308323100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508832775', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000869', 'IHP000869', 'ILCHIGSTD', NULL, 'Glenn', NULL, 'Nelson', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508833500', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000192', 'IHP000192', 'ILCHIGSTD', 'Dupage Medical Group', 'Glenn', NULL, 'Nelson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '7409 Woodridge Dr', 'Woodridge', 'Dupage', 'IL', '60517', '6302411000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508833500', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000352', 'IHP000352', 'ILCHIGSTD', 'Dupage Medical Group', 'Edward', NULL, 'Sherman', 'MD', 'Infectious Disease', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 120', 'Lombard', 'Dupage', 'IL', '60148', '6305454075', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508851114', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000591', 'IHP000591', 'ILCHIGSTD', 'Dupage Medical Group', 'Eugene', NULL, 'Oh', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '420 Warrenville Rd Ste Ste 230', 'Lisle', 'Dupage', 'IL', '60532', '6304326200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508851858', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000415', 'IHP000415', 'ILCHIGSTD', 'Dupage Medical Group', 'Deborah', NULL, 'Wenninger', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1259 Rickert Dr Ste Ste 101', 'Naperville', 'Dupage', 'IL', '60540', '6303551300', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1508852245', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('810660755', 'IHP000255', 'IHP000255', 'ILCHIGSTD', 'Apple a Day Pediatrics', 'John', NULL, 'Webb', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '84 Templeton Dr Ste Ste 106', 'Oswego', 'Kendall', 'IL', '60543', '6305547654', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1508881541', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363862327', 'IHP000697', 'IHP000697', 'ILCHIGSTD', 'Midwest Ent Consultants, Ltd', 'Joseph', NULL, 'Donzelli', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '1247 Rickert  Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6304202323', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1508938952', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000785', 'IHP000785', 'ILCHIGSTD', 'Edward Medical Group-Ob/Gyn Naperville', 'Thomas', NULL, 'Chen', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 406', 'Naperville', 'Dupage', 'IL', '60540', '6309619485', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1518040401', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000330', 'IHP000330', 'ILCHIGSTD', 'Dupage Medical Group', 'Ciaran', NULL, 'Bradley', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 350', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6307901700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518043603', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000675', 'IHP000675', 'ILCHIGSTD', 'Suburban Lung Associates', 'Marilyn', NULL, 'Borkgren', 'NP', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1518919521', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000280', 'IHP000280', 'ILCHIGSTD', 'Dupage Medical Group', 'Jacqueline', NULL, 'Moran', 'MD', 'Allergy and Immunology', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 220', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6305457833', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518934967', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000968', 'IHP000968', 'ILCHIGSTD', NULL, 'Stephen', NULL, ' Pierson', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518935360', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('362657618', 'IHP000199', 'IHP000199', 'ILCHIGSTD', 'Dupage Medical Group', 'Stephen', NULL, ' Pierson', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1800 N Main St', 'Wheaton', 'Dupage', 'IL', '60187', '6306656200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518935360', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000025', 'IHP000025', 'ILCHIGSTD', 'Edward Health Ventures', 'Mary', NULL, 'Dea', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3033 Ogden Ave  Ste 101', 'Lisle', 'Dupage', 'IL', '60532', '6306466200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1518951474', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363862327', 'IHP000700', 'IHP000700', 'ILCHIGSTD', 'Midwest Ent Consultants, Ltd', 'Scott', NULL, 'Kaszuba', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '1247 Rickert Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6304202323', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1518994508', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000395', 'IHP000395', 'ILCHIGSTD', 'Dupage Medical Group', 'Jack', NULL, 'Casini', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 220', 'Lombard', 'Dupage', 'IL', '60148', '6308738700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528040490', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000560', 'IHP000560', 'ILCHIGSTD', 'Dupage Medical Group', 'Bernadette', NULL, 'Bernardo', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '231 S Gary Ave Ste Ste 114', 'Bloomingdale', 'Dupage', 'IL', '60108', '6308938585', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1528046984', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000506', 'IHP000506', 'ILCHIGSTD', 'Dupage Medical Group', 'Christina', NULL, 'Brown ', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '1800 N Main St', 'Wheaton', 'Dupage', 'IL', '60187', '6306656200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528052628', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000142', 'IHP000142', 'ILCHIGSTD', 'Dupage Medical Group', 'Maleeha', NULL, 'Basha', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 408', 'Naperville', 'Dupage', 'IL', '60540', '6309612170', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528054483', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000918', 'IHP000918', 'ILCHIGSTD', NULL, 'Maleeha', NULL, 'Basha', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528054483', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364113345', 'IHP000716', 'IHP000716', 'ILCHIGSTD', 'Womens Center For Health', 'Linda', NULL, 'Anderson', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1220 Hobson Rd Ste Ste 116', 'Naperville', 'Dupage', 'IL', '60540', '6304163300', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1528058195', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000007', 'IHP000007', 'ILCHIGSTD', 'Edward Health Ventures', 'Lara', NULL, 'Ellison', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '2007 95th St  Ste 105', 'Naperville', 'Will', 'IL', '60564', '6306466920', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1528079803', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362821231', 'IHP000645', 'IHP000645', 'ILCHIGSTD', 'Naperville Eye Associates', 'David', NULL, 'Cox', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '1855 Bay Scott Cir', 'Naperville', 'Dupage', 'IL', '60540', '6303575280', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', 'Edward Hospital', NULL, NULL, 'HCFA|UB|', '1528081684', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000759', 'IHP000759', 'ILCHIGSTD', 'Edward Health Ventures-Edward Hematology-Oncology Group ', 'Regina ', NULL, 'Chorley', 'APN', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '24600 W 127th St', 'Plainfield', 'Will', 'IL', '60585', '8157319190', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1528083342', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000543', 'IHP000543', 'ILCHIGSTD', 'Dupage Medical Group', 'Henna', NULL, 'Dracopoulos', 'PA-C', 'Urology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 405', 'Winfield', 'Dupage', 'IL', '60190', '6307901221', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1528109923', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000490', 'IHP000490', 'ILCHIGSTD', 'Dupage Medical Group', 'Jennifer', NULL, 'Speckman', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1948 three Farms Ave', 'Naperville', 'Dupage', 'IL', '60540', '6305478000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528112638', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000784', 'IHP000784', 'ILCHIGSTD', 'Edward Medical Group-General Surgery', 'David', NULL, 'Piazza', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '10 W Martin Ave  Ste 225', 'Naperville', 'Dupage', 'IL', '60540', '6303555633', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1528172897', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000812', 'IHP000812', 'ILCHIGSTD', NULL, 'Jennifer', NULL, 'Brown', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528214715', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000594', 'IHP000594', 'ILCHIGSTD', 'Dupage Medical Group', 'Jennifer', NULL, 'Brown', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6308716699', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528214715', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000900', 'IHP000900', 'ILCHIGSTD', NULL, 'Kaitlin', NULL, 'Mckee', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528218468', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000180', 'IHP000180', 'ILCHIGSTD', 'Dupage Medical Group', 'Kaitlin', NULL, 'Mckee', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2940 Rolling Ridge Dr Ste Ste 300', 'Naperville', 'Will', 'IL', '60564', '6306465800', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528218468', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363082580', 'IHP000651', 'IHP000651', 'ILCHIGSTD', 'Hematology-Oncology Consultants', 'Katy', NULL, 'Goldsborough', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '100 Spalding Dr  Ste 110', 'Naperville', 'Dupage', 'IL', '60540', '6303691501', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1528224128', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363879844', 'IHP000703', 'IHP000703', 'ILCHIGSTD', 'Suburban Gastroenterology', 'Rina', NULL, 'Thakkar', 'NP', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '1243 Rickert Dr', 'Naperville', 'Dupage', 'IL', '60540', '6305276450', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1528318169', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000456', 'IHP000456', 'ILCHIGSTD', 'Dupage Medical Group', 'Lorraine', NULL, 'Hardman', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '801 N Cass Ave  Ste Ste 100', 'Westmont', 'Dupage', 'IL', '60559', '6304567455', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1529263843', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364273103', 'IHP000252', 'IHP000252', 'ILCHIGSTD', 'Dr. Carol R. Weinberg', 'Carol', NULL, 'Weinberg', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '608 S Washington St Ste Ste 300', 'Naperville', 'Dupage', 'IL', '60540', '6307171771', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538128517', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000024', 'IHP000024', 'ILCHIGSTD', 'Edward Health Ventures', 'Robert', NULL, 'Czepiel', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2007 95th St  Ste 105', 'Naperville', 'Will', 'IL', '60564', '6306466920', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538156294', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000002', 'IHP000002', 'ILCHIGSTD', 'Edward Health Ventures', 'Jennifer', NULL, 'Chludzinski  ', 'NP', 'Family Practice', NULL, NULL, NULL, 'O', '2007 95th St ', 'Naperville', 'Dupage', 'IL', '60540', '6306466920', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538156567', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000357', 'IHP000357', 'ILCHIGSTD', 'Dupage Medical Group', 'David', NULL, 'Schlieben', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 102', 'Naperville', 'Dupage', 'IL', '60540', '6308738889', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538166210', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000298', 'IHP000298', 'ILCHIGSTD', 'Dupage Medical Group', 'Evans', NULL, 'Pappas', 'MD', 'Cardiology', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 400', 'Naperville', 'Dupage', 'IL', '60540', '6307182600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538182019', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000402', 'IHP000402', 'ILCHIGSTD', 'Dupage Medical Group', 'Robert', NULL, 'Matlock', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1900 Ogden Ave Ste Ste 210', 'Aurora', 'Dupage', 'IL', '60504', '6303751900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538195995', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000278', 'IHP000278', 'ILCHIGSTD', 'Dupage Medical Group', 'Stephen', NULL, 'Solum', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1900 Ogden Ave Ste Ste 210', 'Aurora', 'Dupage', 'IL', '60504', '6303751900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538405931', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000061', 'IHP000061', 'ILCHIGSTD', 'Edward Health Ventures', 'Cassandra', NULL, 'Crackel   ', 'PA', 'Internal Medicine', NULL, NULL, NULL, 'O', '2007 95th St ', 'Naperville', 'Dupage', 'IL', '60540', '6305277780', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538439799', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000779', 'IHP000779', 'ILCHIGSTD', 'Edward Health Ventures-Linden Oaks Medical Group', 'Christine ', NULL, 'Dahl', 'APN', 'Psychiatry', NULL, NULL, NULL, 'O', '24600 W 127th St Ste B-325', 'Plainfield', 'Will', 'IL', '60585', '8157319100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1548565880', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000845', 'IHP000845', 'ILCHIGSTD', NULL, 'David', NULL, 'Dungan', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558336057', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000117', 'IHP000117', 'ILCHIGSTD', 'Dupage Medical Group', 'David', NULL, 'Dungan', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 130', 'Lombard', 'Dupage', 'IL', '60148', '6306274722', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558336057', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000751', 'IHP000751', 'ILCHIGSTD', 'Edward Health Ventures', 'Maria', NULL, 'Quejada', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '120 Spalding Dr  Ste 111', 'Naperville', 'Dupage', 'IL', '60540', '6305273788', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1558348722', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000676', 'IHP000676', 'ILCHIGSTD', 'Suburban Lung Associates', 'Dorothy', NULL, 'Shapiro', 'NP', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1558357384', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000523', 'IHP000523', 'ILCHIGSTD', 'Dupage Medical Group', 'Katherine', NULL, 'Baker', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '430 Warrenville Rd', 'Lisle', 'Dupage', 'IL', '60532', '6304326745', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558362632', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364020758', 'IHP000711', 'IHP000711', 'ILCHIGSTD', 'James C Ferlmann, MD PC', 'James', NULL, 'Ferlmann', 'MD', 'Plastic Surgery', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste 401', 'Naperville', 'Dupage', 'IL', '60540', '6309228825', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1558369371', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000455', 'IHP000455', 'ILCHIGSTD', 'Dupage Medical Group', 'Lorna', NULL, 'Griffin', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1948 three Farms Ave', 'Naperville', 'Dupage', 'IL', '60540', '6305478000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558387704', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000050', 'IHP000050', 'ILCHIGSTD', 'Edward Health Ventures', 'Edyta', NULL, 'Straczynski', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1220 Hobson Rd  Ste 104', 'Naperville', 'Dupage', 'IL', '60540', '6304161950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1558396085', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('30442503', 'IHP000065', 'IHP000065', 'ILCHIGSTD', 'Ashok H Bhaskar MD', 'Ashok', NULL, 'Bhaskar', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2250 S Weber Rd Ste ', 'Crest Hill', 'Will', 'IL', '60403', '8157441600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1558402958', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('510423681', 'IHP000739', 'IHP000739', 'ILCHIGSTD', 'Aishling Obstetrics and Gynecology', 'James', NULL, 'Hawkins', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '831 E Sandhurst Dr Ste ', 'Sandwich', 'Dekalb', 'IL', '60548', '8157861088', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1558421875', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000842', 'IHP000842', 'ILCHIGSTD', NULL, 'Cynthia', NULL, 'Urbanowicz', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558533596', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000226', 'IHP000226', 'ILCHIGSTD', 'Dupage Medical Group', 'Cynthia', NULL, 'Urbanowicz', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '3743 Highland Ave Ste Ste 1003', 'Downers Grove', 'Dupage', 'IL', '60515', '6309646049', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558533596', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000488', 'IHP000488', 'ILCHIGSTD', 'Dupage Medical Group', 'Andrea', NULL, 'San Luis', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 240', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6305457801', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558657767', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363879844', 'IHP000705', 'IHP000705', 'ILCHIGSTD', 'Suburban Gastroenterology', 'Sushama', NULL, 'Gundlapalli', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '1243 Rickert Dr', 'Naperville', 'Dupage', 'IL', '60540', '6305276450', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1568401529', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000317', 'IHP000317', 'ILCHIGSTD', 'Dupage Medical Group', 'Rameez', NULL, 'Alasadi', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 208', 'Naperville', 'Dupage', 'IL', '60540', '6307172600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1568452712', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000448', 'IHP000448', 'ILCHIGSTD', 'Dupage Medical Group', 'John', NULL, 'Diggle', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1948 three Farms Ave', 'Naperville', 'Dupage', 'IL', '60540', '6305478000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568496693', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364430139', 'IHP000731', 'IHP000731', 'ILCHIGSTD', 'Mary K Deherrera-Codo, MD', 'Mary', NULL, 'Deherrera Codo', 'MD', 'Endocrinology', NULL, NULL, NULL, 'O', '720 S Brom Dr Ste 204', 'Naperville', 'Dupage', 'IL', '60540', '6305481332', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1568504439', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000465', 'IHP000465', 'ILCHIGSTD', 'Dupage Medical Group', 'Debra', NULL, 'Kautz', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '300 S County Farm Rd Ste Ste A', 'Wheaton', 'Dupage', 'IL', '60187', '6305478045', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568551141', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000781', 'IHP000781', 'ILCHIGSTD', 'Edward Medical Group-General Surgery', 'Elizabeth', NULL, 'Harvey', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '10 W Martin Ave  Ste 225', 'Naperville', 'Dupage', 'IL', '60540', '6303555633', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1568576783', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000841', 'IHP000841', 'ILCHIGSTD', NULL, 'Corinna', NULL, 'Wojcik', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578523098', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000234', 'IHP000234', 'ILCHIGSTD', 'Dupage Medical Group', 'Corinna', NULL, 'Wojcik', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '3011 Butterfield Rd Ste Ste 240', 'Oak Brook', 'Dupage', 'IL', '60523', '6306288889', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578523098', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000941', 'IHP000941', 'ILCHIGSTD', NULL, 'Paul', NULL, 'Bicek', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578557716', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000101', 'IHP000101', 'ILCHIGSTD', 'Dupage Medical Group', 'Paul', NULL, 'Bicek', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '801 N Cass Ave Ste Ste 300', 'Westmont', 'Dupage', 'IL', '60559', '6309634570', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578557716', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363378337', 'IHP000658', 'IHP000658', 'ILCHIGSTD', 'Suburban Lung Associates', 'David', NULL, 'Mcelligott', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste 200', 'Naperville', 'Dupage', 'IL', '60540', '6303558776', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1578579850', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363737466', 'IHP000687', 'IHP000687', 'ILCHIGSTD', 'Naperville Ear, Nose and Throat', 'Stephen', NULL, 'Kraseman     ', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '10 W Martin Ave  Ste 260', 'Naperville', 'Dupage', 'IL', '60540', '6303555668', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', 'Edward Hospital', NULL, NULL, 'HCFA|UB|', '1578723680', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000595', 'IHP000595', 'ILCHIGSTD', 'Dupage Medical Group', 'Irina', NULL, 'Domjan', 'MD', 'Hospitalist', 'Internal Medicine', NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6308716699', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1578771002', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000515', 'IHP000515', 'ILCHIGSTD', 'Dupage Medical Group', 'Andrew', NULL, 'Korcek', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 405', 'Winfield', 'Dupage', 'IL', '60190', '6308716699', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588630495', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000291', 'IHP000291', 'ILCHIGSTD', 'Dupage Medical Group', 'Dennis', NULL, 'Karsh', 'MD', 'Cardiology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 300', 'Winfield', 'Dupage', 'IL', '60190', '6309338100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1588630552', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000324', 'IHP000324', 'ILCHIGSTD', 'Dupage Medical Group', 'Adam', NULL, 'Klugman', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 208', 'Naperville', 'Dupage', 'IL', '60540', '6307172600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1588630669', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364028976', 'IHP000714', 'IHP000714', 'ILCHIGSTD', 'Digestive Health Services', 'James', NULL, 'Clark', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '3825 Highland Ave Ste Twr 2 #302', 'Downers Grove', 'Dupage', 'IL', '60515', '6304349312', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1588640650', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000058', 'IHP000058', 'ILCHIGSTD', 'Edward Health Ventures-Edward Medical Group', 'Sandra ', NULL, 'Mazur', 'NP', 'Family Practice', NULL, NULL, NULL, 'O', '130 Weber Rd Ste 100', 'Bolingbrook', 'Will', 'IL', '60440', '6306465777', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1588651509', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364270595', 'IHP000728', 'IHP000728', 'ILCHIGSTD', 'Riaz Baber, MD', 'Glen', NULL, 'Cannon', 'LCPC', 'Counseling', NULL, NULL, NULL, 'O', '1460 Bond St Ste 120', 'Naperville', 'Dupage', 'IL', '60563', '6308590120', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588749550', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000286', 'IHP000286', 'ILCHIGSTD', 'Dupage Medical Group', 'Sharon', NULL, 'Cline', 'MD', 'Cardiology', NULL, NULL, NULL, 'O', '100 Spalding Dr Ste Ste 212', 'Naperville', 'Dupage', 'IL', '60540', '6303574111', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1588750327', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('364028976', 'IHP000712', 'IHP000712', 'ILCHIGSTD', 'Digestive Health Services', 'Lesley', NULL, 'Dawravoo', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '3825 Highland Ave Ste Twr 2 #302', 'Downers Grove', 'Dupage', 'IL', '60515', '6304349312', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1588820781', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000955', 'IHP000955', 'ILCHIGSTD', NULL, 'Rosanne', NULL, 'Browne', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598049645', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000106', 'IHP000106', 'ILCHIGSTD', 'Dupage Medical Group', 'Rosanne', NULL, 'Browne', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1800 N Main St', 'Wheaton', 'Dupage', 'IL', '60187', '6305106900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598049645', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000473', 'IHP000473', 'ILCHIGSTD', 'Dupage Medical Group', 'Laura', NULL, 'Marzulli', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1130 Stearns Rd ', 'Bartlett', 'Dupage', 'IL', '60103', '6305456050', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598854317', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000600', 'IHP000600', 'ILCHIGSTD', 'Dupage Medical Group', 'Reena', NULL, 'Julka ', 'MD', 'Hospitalist', 'Internal Medicine', NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 400', 'Winfield', 'Dupage', 'IL', '60190', '6304699200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1598985525', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000311', 'IHP000311', 'ILCHIGSTD', 'Dupage Medical Group', 'Kelly', NULL, 'Stankiewicz', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '2155 Citygate Ln Ste Ste 225', 'Naperville', 'Dupage', 'IL', '60563', '6305475040', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1598987307', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000363', 'IHP000363', 'ILCHIGSTD', 'Dupage Medical Group', 'Jason', NULL, 'Parikh', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '908 N Elm St Ste Ste 110', 'Hinsdale', 'Dupage', 'IL', '60521', '6309868770', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609032218', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000316', 'IHP000316', 'ILCHIGSTD', 'Dupage Medical Group', 'Anju', NULL, 'Paul', 'MD', 'Endocrinology', NULL, NULL, NULL, 'O', '1020 E Ogden Ave Ste Ste 304', 'Naperville', 'Dupage', 'IL', '60563', '6307894910', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1609032903', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000325', 'IHP000325', 'ILCHIGSTD', 'Dupage Medical Group', 'Thomas', NULL, 'Lee', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste LL01', 'Winfield', 'Dupage', 'IL', '60190', '6307172600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1609808088', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363653432', 'IHP000682', 'IHP000682', 'ILCHIGSTD', 'Midwest Cardiac Consultants', 'Zubair', NULL, 'Syed', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '4121 Fairview Ave Ste 103B', 'Downers Grove', 'Dupage', 'IL', '60515', '6308520230', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1609819598', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000945', 'IHP000945', 'ILCHIGSTD', NULL, 'Raymond', NULL, 'Rojas', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609844273', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000208', 'IHP000208', 'ILCHIGSTD', 'Dupage Medical Group', 'Raymond', NULL, 'Rojas', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1124 Stearns Rd', 'Bartlett', 'Dupage', 'IL', '60103', '6302137788', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609844273', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000403', 'IHP000403', 'ILCHIGSTD', 'Dupage Medical Group', 'Brian', NULL, 'Murphy', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1900 Ogden Ave Ste Ste 210', 'Aurora', 'Dupage', 'IL', '60504', '6303751900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1609862325', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000481', 'IHP000481', 'ILCHIGSTD', 'Dupage Medical Group', 'Deven', NULL, 'Parekh', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2155 Citygate Ln Ste Ste 115', 'Naperville', 'Dupage', 'IL', '60563', '6309462100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609882935', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000454', 'IHP000454', 'ILCHIGSTD', 'Dupage Medical Group', 'Tiffany', NULL, 'Green', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste L10', 'Lombard', 'Dupage', 'IL', '60148', '6308738860', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619012523', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('363879844', 'IHP000708', 'IHP000708', 'ILCHIGSTD', 'Suburban Gastroenterology', 'Shivani Jain', NULL, 'Kiriluk           ', 'MD', 'Gastroenterolgy', NULL, NULL, NULL, 'O', '1243 Rickert Dr', 'Naperville', 'Dupage', 'IL', '60540', '6305276450', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1619125598', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000035', 'IHP000035', 'ILCHIGSTD', 'Edward Health Ventures-Edward Medical Group', 'Kaleem', NULL, 'Khan ', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2132 Deep Water Ln Ste 228', 'Naperville', 'Will', 'IL', '60564', '6309221400', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1619917713', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000833', 'IHP000833', 'ILCHIGSTD', NULL, 'Brett', NULL, 'Hampson', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619922705', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000138', 'IHP000138', 'ILCHIGSTD', 'Dupage Medical Group', 'Brett', NULL, 'Hampson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '430 Warrenville Rd Ste Ste 230', 'Lisle', 'Dupage', 'IL', '60532', '6304326200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619922705', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000526', 'IHP000526', 'ILCHIGSTD', 'Dupage Medical Group', 'L. Douglas', NULL, 'Graham', 'MD', 'Rheumatology', NULL, NULL, NULL, 'O', '801 N Cass Ave Ste Ste 150', 'Westmont', 'Dupage', 'IL', '60559', '6302680200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619932027', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000631', 'IHP000631', 'ILCHIGSTD', 'Dupage Medical Group', 'Michael,D', NULL, 'Lavine', 'MD', 'Radiology', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 110', 'Glen Ellyn', 'Dupage', 'IL', '60137', '6305457880', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619943586', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000519', 'IHP000519', 'ILCHIGSTD', 'Dupage Medical Group', 'John', NULL, 'Porcelli', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '3825 Highland Ave Ste Ste 310', 'Downers Grove', 'Dupage', 'IL', '60515', '6308716699', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619944675', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000300', 'IHP000300', 'ILCHIGSTD', 'Dupage Medical Group', 'Michael', NULL, 'Schmidt', 'MD', 'Cardiology', NULL, NULL, NULL, 'O', '25 N Winfield Rd Ste Ste 300', 'Winfield', 'Dupage', 'IL', '60190', '6309338100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1619945086', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000806', 'IHP000806', 'ILCHIGSTD', NULL, 'Dominic', NULL, 'Costabile', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629043195', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000747', 'IHP000747', 'ILCHIGSTD', 'Edward Health Ventures', 'Mansoina', NULL, 'Baweja', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '120 Spalding Dr  Ste 111', 'Naperville', 'Dupage', 'IL', '60540', '6305273788', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1629052089', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000894', 'IHP000894', 'ILCHIGSTD', NULL, 'Jonathan', NULL, 'Delew', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629060710', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000113', 'IHP000113', 'ILCHIGSTD', 'Dupage Medical Group', 'Jonathan', NULL, 'Delew', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 310', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6307901790', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629060710', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000063', 'IHP000063', 'ILCHIGSTD', 'Edward Health Ventures', 'Stephanie', NULL, 'Dressler    ', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '1220 Hobson Rd Ste 104', 'Naperville', 'Dupage', 'IL', '60540', '6305277780', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1629068234', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000351', 'IHP000351', 'ILCHIGSTD', 'Dupage Medical Group', 'Nozaina', NULL, 'Aftab', 'MD', 'Infectious Disease', NULL, NULL, NULL, 'O', '1801 S Highland Ave Ste Ste 120', 'Lombard', 'Dupage', 'IL', '60148', '6305454075', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629258662', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('581672987', 'IHP000006', 'IHP000006', 'ILCHIGSTD', 'Edward Health Ventures', 'Hiam', NULL, 'Eldewek', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '1220 Hobson Rd  Ste 104', 'Naperville', 'Dupage', 'IL', '60540', '6304161950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1639128309', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000863', 'IHP000863', 'ILCHIGSTD', NULL, 'Eva', NULL, 'Wyrwa', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639139165', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000236', 'IHP000236', 'ILCHIGSTD', 'Dupage Medical Group', 'Eva', NULL, 'Wyrwa', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 210', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6304697700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639139165', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000534', 'IHP000534', 'ILCHIGSTD', 'Dupage Medical Group', 'Adam', NULL, 'Mollsen', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste Ste 400', 'Naperville', 'Dupage', 'IL', '60540', '6309672225', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1639140338', 0, 'Y', 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000580', 'IHP000580', 'ILCHIGSTD', 'Dupage Medical Group', 'Amy', NULL, 'Stoeffler', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '120 Spalding Dr Ste Ste 309', 'Naperville', 'Dupage', 'IL', '60540', '6308938585', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1639143787', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000535', 'IHP000535', 'ILCHIGSTD', 'Dupage Medical Group', 'Julio', NULL, 'Gonzalez', 'MD', 'Sports Medicine', NULL, NULL, NULL, 'O', '430 Pennsylvania Ave Ste Ste 240', 'Glen Ellyn,', 'Dupage', 'IL', '60137', '6307901872', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1639144579', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000510', 'IHP000510', 'ILCHIGSTD', 'Dupage Medical Group', 'Samuel', NULL, 'Vinci', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '4115 Fairview Ave', 'Downers Grove', 'Dupage', 'IL', '60515', '6309681881', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639165467', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000950', 'IHP000950', 'ILCHIGSTD', NULL, 'Robert', NULL, 'Carbone', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639167919', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000107', 'IHP000107', 'ILCHIGSTD', 'Dupage Medical Group', 'Robert', NULL, 'Carbone', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '908 N Elm St Ste Ste 301', 'Hinsdale', 'Dupage', 'IL', '60521', '6303233540', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639167919', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('362657618', 'IHP000868', 'IHP000868', 'ILCHIGSTD', NULL, 'Glenn', NULL, 'Grobe', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1100 W 31st St Ste 400', 'Downers Grove', 'Dupage', 'IL', '60515', '6309427950', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639246671', 0, NULL, 1, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL);
