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
('362711176', 'ELPPA0415', 'ELPPA0415', 'ILCHIGSTD', 'Associated Anesthesiologists of Joliet  ', 'Mauricio', '', 'Orbegozo', 'MD', 'Anesthesiology', '', '', NULL, 'O', '301 N Madison St Ste 306', 'Joliet', 'Will', 'IL', '60435', '8157256331', '8157254709', '301 N Madison St Ste 306', 'Joliet', 'Will', 'IL', '60435', '8157256331', '8157254709', 'CHIGP1', 'CHIHCPCS13', NULL, '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1851359301', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.5273, -88.1346, NULL, NULL),
('362711176', 'ELPPA0416', 'ELPPA0416', 'ILCHIGSTD', 'Associated Anesthesiologists of Joliet  ', 'Mauricio', '', 'Orbegozo', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO Box 936', 'Bedford Park', 'Cook', 'IL', '60499', '8157256331', '8157254709', 'PO Box 936', 'Bedford Park', 'Cook', 'IL', '60499', '8157256331', '8157254709', 'CHIGP1', 'CHIHCPCS13', NULL, '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1851359301', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('363915732', 'ELPPA0417', 'ELPPA0417', 'ILCHIGSTD', 'Joliet Oncology - Hematology Associates', 'Nafisa', 'D', 'Burhani', 'MD', 'Oncology', '', '', NULL, 'O', '2614 W Jefferson St', 'Joliet', 'Will', 'IL', '60435', '8157251355', '8157259861', '2614 W Jefferson St', 'Joliet', 'Will', 'IL', '60435', '8157251355', '8157259861', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Elgin', NULL, NULL, NULL, 'HCFA|UB|', '1851386460', 0, 'N', 0, '2013-06-20', NULL, NULL, 41.522, -88.1474, NULL, NULL),
('203872453', 'ELPPA0420', 'ELPPA0420', 'ILCHIGSTD', 'Prairie Rheumatology Associates', 'Saba', 'Y', 'Ahmed', 'MD', 'Rheumatology', '', '', NULL, 'B', '10660 W 143 ST Ste B', 'Orland Park ', 'Cook', 'IL', '60462', '8157447246', '8157447346', '10660 W 143 ST Ste B', 'Orland Park ', 'Cook', 'IL', '60462', '8157447246', '8157447346', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', '2013-05-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1861448003', 0, 'Y', 0, '2013-07-11', NULL, NULL, 0, 0, NULL, NULL),
('203872453', 'ELPPA0419', 'ELPPA0419', 'ILCHIGSTD', 'Prairie Rheumatology Associates', 'Saba', 'Y', 'Ahmed', 'MD', 'Rheumatology', '', '', NULL, 'O', '903 129th Infantry Ste 600', 'Joliet', 'Will', 'IL', '60435', '8157447246', '8157447346', '903 129th Infantry Ste 600', 'Joliet', 'Will', 'IL', '60435', '8157447246', '8157447346', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', '2013-05-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1861448003', 0, 'N', 0, '2013-07-11', NULL, NULL, 0, 0, NULL, NULL),
('453136848', 'ELPPA0421', 'ELPPA0421', 'ILCHIGSTD', 'EMP of Will County', 'Ross', '', 'Tannebaum', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '333 N Madison St', 'Joliet', 'Will', 'IL', '60435', '8157257133', NULL, '333 N Madison St', 'Joliet', 'Will', 'IL', '60435', '8157257133', '', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861492225', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.528, -88.1346, NULL, NULL),
('453136848', 'ELPPA0422', 'ELPPA0422', 'ILCHIGSTD', 'EMP of Will County', 'Ross', '', 'Tannebaum', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '4535 Dressler Rd', 'Canton', 'Stark', 'OH', '44718', '8157257133', NULL, '4535 Dressler Rd', 'Canton', 'Stark', 'OH', '44718', '8157257133', '', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861492225', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('363915732', 'ELPPA0423', 'ELPPA0423', 'ILCHIGSTD', 'Joliet Oncology Hematology', 'Arvind', '', 'Kumar', 'MD', 'Oncology', '', '', NULL, 'O', '2614 W Jefferson St', 'Joliet', 'Will', 'IL', '60435', '8157251355', '8157259861', '2614 W Jefferson St', 'Joliet', 'Will', 'IL', '60435', '8157251355', '8157259861', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1861590689', 0, 'N', 0, '2013-04-03', NULL, NULL, 41.522, -88.1474, NULL, NULL),
('453136848', 'ELPPA0425', 'ELPPA0425', 'ILCHIGSTD', 'EMP of Will County', 'Peter', '', 'Stockmal', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '333 N Madison St', 'Joliet', 'Will', 'IL', '60435', '8157257133', NULL, '333 N Madison St', 'Joliet', 'Will', 'IL', '60435', '8157257133', '', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1871593236', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.528, -88.1346, NULL, NULL),
('453136848', 'ELPPA0426', 'ELPPA0426', 'ILCHIGSTD', 'EMP of Will County', 'Peter', '', 'Stockmal', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '4535 Dressler Rd', 'Canton', 'Stark', 'OH', '44718', '8157257133', NULL, '4535 Dressler Rd', 'Canton', 'Stark', 'OH', '44718', '8157257133', '', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1871593236', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364195126', 'ELPPA0427', 'ELPPA0427', 'ILCHIGSTD', 'Neuroscience Institute at Provena', 'Aamir', '', 'Badruddin', 'MD', 'Neurosurgery', '', '', NULL, 'O', '301 N Madison St Ste 300', 'Joliet', 'Will', 'IL', '60435', '8157284367', '8157254863', '301 N Madison St Ste 300', 'Joliet', 'Will', 'IL', '60435', '8157284367', '8157254863', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1871769331', 0, 'N', 0, '2013-02-15', NULL, NULL, 41.5273, -88.1346, NULL, NULL),
('364195126', 'ELPPA0428', 'ELPPA0428', 'ILCHIGSTD', 'Neuroscience Institute at Provena', 'Aamir', '', 'Badruddin', 'MD', 'Neurosurgery', '', '', NULL, 'B', '75 Remittance Dr Ste 1577', 'Chicago', 'Cook', 'IL', '60675', '8157284367', '8157254863', '75 Remittance Dr Ste 1577', 'Chicago', 'Cook', 'IL', '60675', '8157284367', '8157254863', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1871769331', 0, 'Y', 0, '2013-02-15', NULL, NULL, 0, 0, NULL, NULL),
('203872453', 'ELPPA0429', 'ELPPA0429', 'ILCHIGSTD', 'Prairie Rheumatology Associates', 'Maria', '', 'Francis', 'DO', 'Rheumatology', '', '', NULL, 'O', '903 129th Infantry Ste 600', 'Joliet', 'Will', 'IL', '60435', '8157447246', '8157447346', '903 129th Infantry Ste 600', 'Joliet', 'Will', 'IL', '60435', '8157447246', '8157447346', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', '2013-05-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1871828780', 0, 'N', 0, '2013-05-20', NULL, NULL, 0, 0, NULL, NULL),
('203872453', 'ELPPA0430', 'ELPPA0430', 'ILCHIGSTD', 'Prairie Rheumatology Associates', 'Maria', '', 'Francis', 'DO', 'Rheumatology', '', '', NULL, 'B', '903 129th Infantry Dr Ste 600', 'Joliet', 'Will', 'IL', '60435', '8157447246', '8157447346', '903 129th Infantry Dr Ste 600', 'Joliet', 'Will', 'IL', '60435', '8157447246', '8157447346', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', '2013-05-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1871828780', 0, 'Y', 0, '2013-05-20', NULL, NULL, 0, 0, NULL, NULL),
('364121175', 'ELPPA0431', 'ELPPA0431', 'ILCHIGSTD', 'ENT Surgical Consultants  ', 'Scott', '', 'DiVenere', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '2201 Glenwood Ave', 'Joliet', 'Will', 'IL', '60435', '8157251191', '8157252048', '2201 Glenwood Ave', 'Joliet', 'Will', 'IL', '60435', '8157251191', '8157252048', 'CHIGP1', 'CHIHCPCS13', NULL, '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', NULL, 'HCFA|UB|', '1881677714', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.5296, -88.1347, NULL, NULL),
('362711176', 'ELPPA0433', 'ELPPA0433', 'ILCHIGSTD', 'Associated Anesthesiologists of Joliet  ', 'Aarchita', 'H', 'Buddhadev', 'MD', 'Anesthesiology', '', '', NULL, 'O', '301 N Madison St Ste 306', 'Joliet', 'Will', 'IL', '60435', '7087474000', '7085033806', '301 N Madison St Ste 306', 'Joliet', 'Will', 'IL', '60435', '7087474000', '7085033806', 'CHIGP1', 'CHIHCPCS13', NULL, '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881997633', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.5273, -88.1346, NULL, NULL),
('362711176', 'ELPPA0434', 'ELPPA0434', 'ILCHIGSTD', 'Associated Anesthesiologists of Joliet  ', 'Aarchita', 'H', 'Buddhadev', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO Box 936', 'Bedford Park', 'Cook', 'IL', '60499', '7087474000', '7085033806', 'PO Box 936', 'Bedford Park', 'Cook', 'IL', '60499', '7087474000', '7085033806', 'CHIGP1', 'CHIHCPCS13', NULL, '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881997633', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364115235', 'ELPPA0435', 'ELPPA0435', 'ILCHIGSTD', 'Heartland Cardiovascular Center', 'Daniele', 'P', 'De Girolami', 'MD', 'Cardiology', '', '', NULL, 'O', '301 N Madison St Ste 207', 'Joliet', 'Will', 'IL', '60435', '8157401900', '8157293294', '301 N Madison St Ste 207', 'Joliet', 'Will', 'IL', '60435', '8157401900', '8157293294', 'CHIGP1', 'CHIHCPCS13', NULL, '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Medical Center', '', '', '', 'HCFA|UB|', '1891743100', 0, 'N', 0, '2013-07-15', NULL, NULL, 41.5273, -88.1346, NULL, NULL),
('364121175', 'ELPPA0437', 'ELPPA0437', 'ILCHIGSTD', 'ENT Surgical Consultants  ', 'Rajeev', '', 'Mehta', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '2201 Glenwood Ave', 'Joliet', 'Will', 'IL', '60435', '8157251191', '8157252048', '2201 Glenwood Ave', 'Joliet', 'Will', 'IL', '60435', '8157251191', '8157252048', 'CHIGP1', 'CHIHCPCS13', NULL, '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', NULL, 'HCFA|UB|', '1891778718', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.5296, -88.1347, NULL, NULL),
('453136848', 'ELPPA0439', 'ELPPA0439', 'ILCHIGSTD', 'EMP of Will County', 'Andrew', '', 'Zwolski', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '333 N Madison St', 'Joliet', 'Will', 'IL', '60435', '8157257133', NULL, '333 N Madison St', 'Joliet', 'Will', 'IL', '60435', '8157257133', '          ', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', '2013-07-25', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1891795126', 0, 'Y', 0, '2013-08-21', NULL, NULL, 41.5279, -88.1354, NULL, NULL),
('453136848', 'ELPPA0440', 'ELPPA0440', 'ILCHIGSTD', 'EMP of Will County', 'Andrew', '', 'Zwolski', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '4535 Dressler Rd', 'Canton', 'Stark', 'OH', '44718', '8157257133', NULL, '4535 Dressler Rd', 'Canton', 'Stark', 'OH', '44718', '8157257133', '          ', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', '2013-07-25', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1891795126', 0, 'Y', 0, '2013-08-21', NULL, NULL, 0, 0, NULL, NULL),
('364115235', 'ELPPA0441', 'ELPPA0441', 'ILCHIGSTD', 'Heartland Cardiovascular Center', 'JoAnn', '', 'Donoghue', 'DO', 'Cardiology', '', '', NULL, 'O', '301 N Madison St Ste 207', 'Joliet', 'Will', 'IL', '60435', '8157401900', '8157252411', '301 N Madison St Ste 207', 'Joliet', 'Will', 'IL', '60435', '8157401900', '8157252411', 'CHIGP1', 'CHIHCPCS13', NULL, '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', NULL, 'HCFA|UB|', '1902850829', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.5273, -88.1346, NULL, NULL),
('453136848', 'ELPPA0443', 'ELPPA0443', 'ILCHIGSTD', 'EMP of Will County', 'Christopher', '', 'Yenter', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '333 N Madison St', 'Joliet', 'Will', 'IL', '60435', '8157257133', NULL, '333 N Madison St', 'Joliet', 'Will', 'IL', '60435', '8157257133', '', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912162314', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.528, -88.1346, NULL, NULL),
('453136848', 'ELPPA0444', 'ELPPA0444', 'ILCHIGSTD', 'EMP of Will County', 'Christopher', '', 'Yenter', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '4535 Dressler Rd', 'Canton', 'Stark', 'OH', '44718', '8157257133', NULL, '4535 Dressler Rd', 'Canton', 'Stark', 'OH', '44718', '8157257133', '', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912162314', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364121175', 'ELPPA0445', 'ELPPA0445', 'ILCHIGSTD', 'ENT Surgical Consultants  ', 'Sung', '', 'Chung', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '2201 Glenwood Ave', 'Joliet', 'Will', 'IL', '60435', '8157251191', '8157252048', '2201 Glenwood Ave', 'Joliet', 'Will', 'IL', '60435', '8157251191', '8157252048', 'CHIGP1', 'CHIHCPCS13', NULL, '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', NULL, 'HCFA|UB|', '1912980574', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.5296, -88.1347, NULL, NULL),
('453136848', 'ELPPA0447', 'ELPPA0447', 'ILCHIGSTD', 'EMP of Will County', 'Steve', '', 'Vulich', 'DO', 'Emergency Medicine', '', '', NULL, 'O', '333 N Madison St', 'Joliet', 'Will', 'IL', '60435', '8157257133', NULL, '333 N Madison St', 'Joliet', 'Will', 'IL', '60435', '8157257133', '', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1922008242', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.528, -88.1346, NULL, NULL),
('453136848', 'ELPPA0448', 'ELPPA0448', 'ILCHIGSTD', 'EMP of Will County', 'Steve', '', 'Vulich', 'DO', 'Emergency Medicine', '', '', NULL, 'B', '4535 Dressler Rd', 'Canton', 'Stark', 'OH', '44718', '8157257133', NULL, '4535 Dressler Rd', 'Canton', 'Stark', 'OH', '44718', '8157257133', '', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1922008242', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364152399', 'ELPPA0449', 'ELPPA0449', 'ILCHIGSTD', 'Springfield OB-GYN Group', 'Jose', 'F', 'Battistini', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '301 Springfield', 'Joliet', 'Will', 'IL', '60435', '8157290330', '8157290566', '301 Springfield', 'Joliet', 'Will', 'IL', '60435', '8157290330', '8157290566', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', '2013-04-02', 0, 0, 0, 'Presence Saint Joseph Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1922161827', 0, 'N', 0, '2013-04-03', NULL, NULL, 0, 0, NULL, NULL),
('364115235', 'ELPPA0451', 'ELPPA0451', 'ILCHIGSTD', 'Heartland Cardiovascular Center', 'Chris', '', 'Kolyvas', 'MD', 'Cardiology', '', '', NULL, 'O', '301 N Madison St Ste 207', 'Joliet', 'Will', 'IL', '60435', '8157401900', '8157252411', '301 N Madison St Ste 207', 'Joliet', 'Will', 'IL', '60435', '8157401900', '8157252411', 'CHIGP1', 'CHIHCPCS13', NULL, '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', NULL, 'HCFA|UB|', '1932157302', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.5273, -88.1346, NULL, NULL),
('203996471', 'ELPPA0453', 'ELPPA0453', 'ILCHIGSTD', 'Allergy and Asthma Associates of Joliet', 'Miguel', 'De Guzman', 'Camara', 'MD', 'Allergy and Immunology', '', '', NULL, 'O', '2000 Glenwood Ave Ste 100', 'Joliet', 'Will', 'IL', '60435', '8157411212', '7084227342', '2000 Glenwood Ave Ste 100', 'Joliet', 'Will', 'IL', '60435', '8157411212', '7084227342', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1932380078', 0, 'N', 0, '2013-04-03', NULL, NULL, 41.5298, -88.1298, NULL, NULL),
('753091373', 'ELPPA0455', 'ELPPA0455', 'ILCHIGSTD', 'Midwest Rehabilitation Associates', 'Frances', 'G', 'Deppe', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '310 N Hammes Ave Ste 202', 'Joliet', 'Will', 'IL', '60435', '8157412201', '8157412285', '310 N Hammes Ave Ste 202', 'Joliet', 'Will', 'IL', '60435', '8157412201', '8157412285', 'CHIGP1', 'CHIHCPCS13', NULL, '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1942215223', 0, 'Y', 0, '2013-03-29', NULL, NULL, 41.5276, -88.132, NULL, NULL),
('362704738', 'ELPPA0458', 'ELPPA0458', 'ILCHIGSTD', 'Nuclear Oncology  ', 'Ommar', 'Tin', 'Hla', 'MD', 'Radiation Oncology', '', '', NULL, 'B', '15 Salt Creek Ln Ste 119', 'Hinsdale', 'Dupage', 'IL', '60521', '8157251355', '8157259861', '15 Salt Creek Ln Ste 119', 'Hinsdale', 'Dupage', 'IL', '60521', '8157251355', '8157259861', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1942225511', 0, 'Y', 0, '2013-07-25', NULL, NULL, 0, 0, NULL, NULL),
('362704738', 'ELPPA0457', 'ELPPA0457', 'ILCHIGSTD', 'Nuclear Oncology  ', 'Ommar', 'Tin', 'Hla', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '2614 Jefferson St', 'Joliet', 'Will', 'IL', '60435', '8157251355', '8157259861', '2614 Jefferson St', 'Joliet', 'Will', 'IL', '60435', '8157251355', '8157259861', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 6, '2013-01-01', '2013-01-01', 0, 0, 0, 'Elmhurst Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1942225511', 0, 'N', 0, '2013-07-25', NULL, NULL, 41.5212, -88.1479, NULL, NULL),
('453136848', 'ELPPA0459', 'ELPPA0459', 'ILCHIGSTD', 'EMP of Will County', 'Leo', '', 'Boggs', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '333 N Madison St', 'Joliet', 'Will', 'IL', '60435', '8157257133', NULL, '333 N Madison St', 'Joliet', 'Will', 'IL', '60435', '8157257133', '', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1942232962', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.528, -88.1346, NULL, NULL),
('453136848', 'ELPPA0460', 'ELPPA0460', 'ILCHIGSTD', 'EMP of Will County', 'Leo', '', 'Boggs', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '4535 Dressler Rd', 'Canton', 'Stark', 'OH', '44718', '8157257133', NULL, '4535 Dressler Rd', 'Canton', 'Stark', 'OH', '44718', '8157257133', '', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1942232962', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('362985395', 'ELPPA0461', 'ELPPA0461', 'ILCHIGSTD', 'Advanced Urology Associates', 'Ryan', '', 'Manecke', 'MD', 'Urology', '', '', NULL, 'O', '1541 Riverboat Ctr Dr', 'Joliet', 'Will', 'IL', '60431', '8154094930', '8157267502', '1541 Riverboat Ctr Dr', 'Joliet', 'Will', 'IL', '60431', '8154094930', '8157267502', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1942289129', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.4948, -88.166, NULL, NULL),
('362830077', 'ELPPA0465', 'ELPPA0465', 'ILCHIGSTD', 'Premier Dermatology', 'Gregory', '', 'Bezanis', 'MD', 'Dermatology', '', '', NULL, 'O', '2051 Plainfield Rd', 'Crest Hill', 'Will', 'IL', '60403', '8157414343', '8157418660', '2051 Plainfield Rd', 'Crest Hill', 'Will', 'IL', '60403', '8157414343', '8157418660', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', '', 'HCFA|UB|', '1952395436', 0, 'N', 0, '2013-07-02', NULL, NULL, 41.5597, -88.1331, NULL, NULL),
('363915732', 'ELPPA0467', 'ELPPA0467', 'ILCHIGSTD', 'Joliet Oncology - Hematology Associates', 'Kulamani', 'M', 'Sivarajan', 'MD', 'Oncology', '', '', NULL, 'O', '2614 W Jefferson St', 'Joliet', 'Will', 'IL', '60435', '8157251355', '8157259861', '2614 W Jefferson St', 'Joliet', 'Will', 'IL', '60435', '8157251355', '8157259861', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', 'Presence Saint Joseph Hospital Chicago', '', NULL, 'HCFA|UB|', '1952396582', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.522, -88.1474, NULL, NULL),
('383701260', 'ELPPA0469', 'ELPPA0469', 'ILCHIGSTD', 'Kidney Care Center', 'Nitesh', NULL, 'Thakker', 'MD', 'Hospitalist', '', '', NULL, 'O', '812 Campus Dr', 'Joliet', 'Will', 'IL', '60435', '8157416830', '8157416832', '812 Campus Dr', 'Joliet', 'Will', 'IL', '60435', '8157416830', '8157416832', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1952480295', 0, 'Y', 0, '2013-01-09', NULL, NULL, 41.5369, -88.148, NULL, NULL),
('383701260', 'ELPPA0470', 'ELPPA0470', 'ILCHIGSTD', 'Kidney Care Center', 'Nitesh', NULL, 'Thakker', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 36', 'Lemont', 'Cook', 'IL', '60439', '8157416830', '8157416832', 'PO Box 36', 'Lemont', 'Cook', 'IL', '60439', '8157416830', '8157416832', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1952480295', 0, 'Y', 0, '2013-01-09', NULL, NULL, 0, 0, NULL, NULL),
('362985395', 'ELPPA0471', 'ELPPA0471', 'ILCHIGSTD', 'Advanced Urology Associates', 'Gregory', '', 'Andros', 'MD', 'Urology', '', '', NULL, 'O', '1541 Riverboat Ctr Dr', 'Joliet', 'Will', 'IL', '60431', '8154094930', '8157267502', '1541 Riverboat Ctr Dr', 'Joliet', 'Will', 'IL', '60431', '8154094930', '8157267502', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', NULL, 'HCFA|UB|', '1962481143', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.4948, -88.166, NULL, NULL),
('364314354', 'ELPPA0474', 'ELPPA0474', 'ILCHIGSTD', 'Provena Hospitalist Group', 'Mary', '', 'Gordon', 'DO', 'Internal Medicine', '', '', NULL, 'B', '25872 Network Pl', 'Chicago', 'Cook', 'IL', '60673', '8157257133', NULL, '25872 Network Pl', 'Chicago', 'Cook', 'IL', '60673', '8157257133', '', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972521367', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364314354', 'ELPPA0473', 'ELPPA0473', 'ILCHIGSTD', 'Provena Hospitalist Group', 'Mary', '', 'Gordon', 'DO', 'Internal Medicine', '', '', NULL, 'O', '334 N Madison St', 'Joliet', 'Will', 'IL', '60435', '8157257133', NULL, '334 N Madison St', 'Joliet', 'Will', 'IL', '60435', '8157257133', '', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972521367', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364121175', 'ELPPA0475', 'ELPPA0475', 'ILCHIGSTD', 'ENT Surgical Consultants  ', 'Thomas', '', 'Kron', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '2201 Glenwood Ave', 'Joliet', 'Will', 'IL', '60435', '8157251191', '8157252048', '2201 Glenwood Ave', 'Joliet', 'Will', 'IL', '60435', '8157251191', '8157252048', 'CHIGP1', 'CHIHCPCS13', NULL, '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', NULL, 'HCFA|UB|', '1972586899', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.5296, -88.1347, NULL, NULL),
('203872453', 'ELPPA0480', 'ELPPA0480', 'ILCHIGSTD', 'Prairie Rheumatology Associates', 'Maria', '', 'Sosenko', 'MD', 'Rheumatology', '', '', NULL, 'B', '10660 W 143 ST Ste B', 'Orland Park ', 'Cook', 'IL', '60462', '8157447246', '8157447346', '10660 W 143 ST Ste B', 'Orland Park ', 'Cook', 'IL', '60462', '8157447246', '8157447346', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', '2013-05-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1982658852', 0, 'Y', 0, '2013-05-20', NULL, NULL, 0, 0, NULL, NULL),
('203872453', 'ELPPA0479', 'ELPPA0479', 'ILCHIGSTD', 'Prairie Rheumatology Associates', 'Maria', '', 'Sosenko', 'MD', 'Rheumatology', '', '', NULL, 'O', '903 129th Infantry Ste 600', 'Joliet', 'Will', 'IL', '60435', '8157447246', '8157447346', '903 129th Infantry Ste 600', 'Joliet', 'Will', 'IL', '60435', '8157447246', '8157447346', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', '2013-05-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1982658852', 0, 'N', 0, '2013-05-20', NULL, NULL, 0, 0, NULL, NULL),
('364195126', 'ELPPA0481', 'ELPPA0481', 'ILCHIGSTD', 'Joliet Pediatric Endocrinology Clinic - PSJMC', 'Tseghai', '', 'Berhe', 'MD', 'Pediatric Endocrinology', '', '', NULL, 'O', '301 N Madison St Ste 302', 'Joliet', 'Will', 'Il', '60435', '8154056285', '8157737724', '301 N Madison St Ste 302', 'Joliet', 'Will', 'Il', '60435', '8154056285', '8157737724', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982678207', 0, 'Y', 0, '2013-02-15', NULL, NULL, 41.5273, -88.1346, NULL, NULL),
('364195126', 'ELPPA0482', 'ELPPA0482', 'ILCHIGSTD', 'Joliet Pediatric Endocrinology Clinic - PSJMC', 'Tseghai', '', 'Berhe', 'MD', 'Pediatric Endocrinology', '', '', NULL, 'B', '75 Remittance Dr Ste 1577', 'Chicago', 'Cook', 'IL', '60675', '8154056285', '8157737724', '75 Remittance Dr Ste 1577', 'Chicago', 'Cook', 'IL', '60675', '8154056285', '8157737724', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982678207', 0, 'Y', 0, '2013-02-15', NULL, NULL, 0, 0, NULL, NULL),
('270959996', 'ELPPA0483', 'ELPPA0483', 'ILCHIGSTD', 'Cardinal Surgical Associates', 'Syed', '', 'Bokhari', 'MD', 'General Surgery', '', '', NULL, 'O', '1051 Essington Rd Ste 230A', 'Joliet', 'Will', 'IL', '60435', '8157300202', '8157300404', '1051 Essington Rd Ste 230A', 'Joliet', 'Will', 'IL', '60435', '8157300202', '8157300404', 'CHIGP1', 'CHIHCPCS13', NULL, '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', NULL, 'HCFA|UB|', '1982691259', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.5408, -88.1608, NULL, NULL),
('270959996', 'ELPPA0484', 'ELPPA0484', 'ILCHIGSTD', 'Cardinal Surgical Associates', 'Syed', '', 'Bokhari', 'MD', 'General Surgery', '', '', NULL, 'B', '10660 W 143 ST Ste B', 'Orland Park ', 'Cook', 'IL', '60462', '8157300202', '8157300404', '10660 W 143 ST Ste B', 'Orland Park ', 'Cook', 'IL', '60462', '8157300202', '8157300404', 'CHIGP1', 'CHIHCPCS13', NULL, '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', NULL, 'HCFA|UB|', '1982691259', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('362830077', 'ELPPA0485', 'ELPPA0485', 'ILCHIGSTD', 'Premier Dermatology', 'Aaron', 'S', 'Cetner', 'MD', 'Dermatology', '', '', NULL, 'O', '2051 Plainfield Rd', 'Crest Hill', 'Will', 'IL', '60403', '8157414343', '8157418660', '2051 Plainfield Rd', 'Crest Hill', 'Will', 'IL', '60403', '8157414343', '8157418660', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', '', 'HCFA|UB|', '1982802245', 0, 'N', 0, '2013-07-02', NULL, NULL, 41.5597, -88.1331, NULL, NULL),
('363971104', 'ELPPA0487', 'ELPPA0487', 'ILCHIGSTD', 'Optima Medical', 'Brian', 'P', 'Ragona', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1050 Essington Rd', 'Joliet', 'Will', 'IL', '60435', '8157290129', '8157291643', '1050 Essington Rd', 'Joliet', 'Will', 'IL', '60435', '8157290129', '8157291643', 'CHIGP1', 'CHIHCPCS13', NULL, '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1992701015', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.5408, -88.1608, NULL, NULL),
('362830077', 'ELPPA0489', 'ELPPA0489', 'ILCHIGSTD', 'Premier Dermatology', 'Michelle', '', 'Pipitone', 'MD', 'Dermatology', '', '', NULL, 'O', '2051 Plainfield Rd', 'Crest Hill', 'Will', 'IL', '60403', '8157414343', '0000000000', '2051 Plainfield Rd', 'Crest Hill', 'Will', 'IL', '60403', '8157414343', '0000000000', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', NULL, 'HCFA|UB|', '1992757066', 0, 'N', 0, '2013-04-03', NULL, NULL, 41.5597, -88.1331, NULL, NULL),
('364195126', 'W12029235', 'W12029235', 'ILCHIGSTD', 'Provena Glenwood Medical Imaging', '', '', 'Provena Glenwood Medical Imaging', '', 'Imaging Center', '', '', NULL, 'O', '2000 Glenwood Dr', 'Joliet', 'Will', 'IL', '60431', '8157417555', NULL, '2000 Glenwood Dr', 'Joliet', 'Will', 'IL', '60431', '8157417555', '          ', 'PRE150ASPDME', 'PRES150', '', '0.00', '30.00', '0.00', 6, '2013-02-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000010043', 0, 'N', 0, '2013-05-24', NULL, NULL, 41.5298, -88.1298, NULL, NULL),
('870299862', 'W42015834', 'W42015834', 'UTMH1', 'LDS Family Services', 'Ken', '', 'Folsom', 'LMFT', 'Mental Health', 'Marriage & Family Therapy', '', NULL, 'B', '125 N State St', 'Salt Lake City', 'Salt Lake', 'UT', '84150', '8013363040', '8013363041', '125 N State St  ', 'Salt Lake City', 'Salt Lake', 'UT', '84150', '8013363040', '8013363041', 'MA', '', '', '0.00', '40.00', '0.00', 8, '2013-02-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558573923', 0, 'N', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('010745486', 'ELPPA0132', 'ELPPA0132', 'ILCHIGSTD', 'City Ctr Healthcare', 'Rajendra', 'M', 'Choksi', 'MD', 'Pediatrics', '', '', NULL, 'B', '6728 Lakeview Ct', 'Woodridge', 'Dupage', 'IL', '60517', '8157260311', '8157260520', '6728 Lakeview Ct', 'Woodridge', 'Dupage', 'IL', '60517', '8157260311', '8157260520', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-02-15', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Elgin', NULL, NULL, NULL, 'HCFA|UB|', '1285630079', 0, 'Y', 0, '2013-05-28', NULL, NULL, 0, 0, NULL, NULL),
('010745486', 'ELPPA0393', 'ELPPA0393', 'ILCHIGSTD', 'City Ctr Healthcare', 'Shanthi', 'R', 'Gopi', 'MD', 'Pediatrics', '', '', NULL, 'O', '300 N Ottawa St', 'Joliet', 'Will', 'IL', '60432', '8157260311', '8157260520', '300 N Ottawa St', 'Joliet', 'Will', 'IL', '60432', '8157260311', '8157260520', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-04-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Elgin', NULL, NULL, NULL, 'HCFA|UB|', '1821012410', 0, 'N', 0, '2013-04-26', NULL, NULL, 41.5297, -88.0831, NULL, NULL),
('010745486', 'ELPPA0394', 'ELPPA0394', 'ILCHIGSTD', 'City Ctr Healthcare', 'Shanthi', 'R', 'Gopi', 'MD', 'Pediatrics', '', '', NULL, 'B', '6728 Lakeview Ct', 'Woodridge', 'Dupage', 'IL', '60517', '8157260311', '8157260520', '6728 Lakeview Ct', 'Woodridge', 'Dupage', 'IL', '60517', '8157260311', '8157260520', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-04-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Elgin', NULL, NULL, NULL, 'HCFA|UB|', '1821012410', 0, 'Y', 0, '2013-04-26', NULL, NULL, 0, 0, NULL, NULL),
('202800071', 'W12027396', 'W12027396', 'UTMH1', 'Alpine Center for Personal Growth', 'Burton', '', 'Fullmer', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'O', '5689 S Redwood Rd Ste 30', 'Salt Lake City', 'Salt Lake', 'UT', '84123', '8012681715', '8012681783', '5689 S Redwood Rd Ste 30', 'Salt Lake City', 'Salt Lake', 'UT', '84123', '8012681715', '8012681783', 'UTMA', '', '', '0.00', '35.00', '0.00', 6, '2013-02-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295087112', 0, 'N', 0, '2013-07-24', NULL, NULL, 0, 0, NULL, NULL),
('263553949', 'W12027319', 'W12027319', 'TXDALSTD', 'Podiatric Medical Partners of Texas', 'Samuel', '', 'Nava', 'DPM', 'Podiatry', '', '', NULL, 'B', 'PO Box 975517', 'Dallas', 'Dallas', 'TX', '75397', '3212072839', '3212562966', 'PO Box 975517', 'Dallas', 'Dallas', 'TX', '75397', '3212072839', '3212562966', 'DALLAS4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Carrollton', NULL, NULL, NULL, 'HCFA|UB|', '1033199963', 0, 'N', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('263553949', 'W12027318', 'W12027318', 'TXDALSTD', 'Podiatric Medical Partners of Texas', 'William', '', 'Arrington', 'DPM', 'Podiatry', '', '', NULL, 'B', 'PO Box 975517', 'Dallas', 'Dallas', 'TX', '75397', '3212072839', '3212562966', 'PO Box 975517', 'Dallas', 'Dallas', 'TX', '75397', '3212072839', '3212562966', 'DALLAS4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1134213812', 0, 'N', 0, '2014-06-17', NULL, NULL, 0, 0, NULL, NULL),
('263553949', 'W12027317', 'W12027317', 'TXDALSTD', 'Podiatric Medical Partners of Texas', 'John', 'R', 'Landry', 'DPM', 'Podiatry', '', '', NULL, 'B', 'PO Box 975517', 'Dallas', 'Dallas', 'TX', '75397', '3212072839', '3212562966', 'PO Box 975517', 'Dallas', 'Dallas', 'TX', '75397', '3212072839', '3212562966', 'DALLAS4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710936158', 0, 'N', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('760555526', 'W12027283', 'W12027283', 'TXHOUSTD', 'Kidney Associates', 'Ruth', '', 'Wintz', 'MD', 'Nephrology', '', '', NULL, 'O', '1415 N Loop W Ste 940', 'Houston', 'Harris', 'TX', '77008', '7136910107', '7136910194', '1415 N Loop W Ste 940', 'Houston', 'Harris', 'TX', '77008', '7136910107', '7136910194', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, '', '', 'HCFA|UB|', '1891728168', 0, 'N', 0, '2012-12-20', NULL, NULL, 29.8123, -95.4253, NULL, NULL),
('760555526', 'W12027260', 'W12027260', 'TXHOUSTD', 'Kidney Associates', '', '', 'Kidney Associates PLLC', '', 'Nephrology', '', '', NULL, 'O', '6624 Fannin St Ste 1400', 'Houston', 'Harris', 'TX', '77030', '7137955511', '7136910194', '6624 Fannin St Ste 1400', 'Houston', 'Harris', 'TX', '77030', '7137955511', '7136910194', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023146560', 0, 'Y', 0, '2012-12-20', NULL, NULL, 29.7096, -95.4011, NULL, NULL),
('760555526', 'W12027291', 'W12027291', 'TXHOUSTD', 'Kidney Associates', 'Wasae', '', 'Tabibi', 'MD', 'Nephrology', '', '', NULL, 'O', '1415 N Loop W Ste 940', 'Houston', 'Harris', 'TX', '77008', '7136910107', '7136910194', '1415 N Loop W Ste 940', 'Houston', 'Harris', 'TX', '77008', '7136910107', '7136910194', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-03-20', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1255336012', 0, 'N', 0, '2013-02-13', NULL, NULL, 29.8123, -95.4253, NULL, NULL),
('760555526', 'W12027269', 'W12027269', 'TXHOUSTD', 'Kidney Associates', 'Emil', '', 'Abdulhayoglu', 'MD', 'Nephrology', '', '', NULL, 'O', '6624 Fannin St Ste 1400', 'Houston', 'Harris', 'TX', '77030', '7137955511', '8325536081', '6624 Fannin St Ste 1400', 'Houston', 'Harris', 'TX', '77030', '7137955511', '8325536081', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'East Houston Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1801860671', 0, 'N', 0, '2013-05-28', NULL, NULL, 29.7096, -95.4011, NULL, NULL),
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('201972784', 'W12027309', 'W12027309', 'TXSATSTD', 'North Hills Family Medicine', 'Dean', 'A', 'Earp', 'MD', 'Family Practice', '', '', NULL, 'O', '150 E Sonterra Ste 220', 'San Antonio', 'Bexar', 'TX', '78258', '2104816800', '2104811444', '150 E Sonterra Ste 220', 'San Antonio', 'Bexar', 'TX', '78258', '2104816800', '2104811444', 'SANANTONIO1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1669420204', 0, 'N', 0, '2014-02-04', NULL, NULL, 29.6162, -98.493, NULL, NULL),
('201972784', 'W12027311', 'W12027311', 'TXSATSTD', 'North Hills Family Medicine', 'Jennifer', 'N', 'Reynard', 'MD', 'Pediatrics', '', '', NULL, 'O', '150 E Sonterra Ste 220', 'San Antonio', 'Bexar', 'TX', '78258', '2104816800', '2104811444', '150 E Sonterra Ste 220', 'San Antonio', 'Bexar', 'TX', '78258', '2104816800', '2104811444', 'SANANTONIO1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2014-02-28', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437119542', 0, 'N', 0, '2014-02-21', NULL, NULL, 29.6162, -98.493, NULL, NULL),
('201972784', 'W12027313', 'W12027313', 'TXSATSTD', 'North Hills Family Medicine', 'Brandon', 'L', 'Bolfing', 'MD', 'Family Practice', '', '', NULL, 'O', '11212 State Hwy 151 Bldg 2, Ste 201', 'San Antonio', 'Bexar', 'TX', '78251', '2106815747', '2106817515', '11212 State Hwy 151 Bldg 2, Ste 201', 'San Antonio', 'Bexar', 'TX', '78251', '2106815747', '2106817515', 'SANANTONIO1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760638407', 0, 'N', 0, '2013-01-07', NULL, NULL, 29.4801, -98.7053, NULL, NULL),
('201972784', 'W12027315', 'W12027315', 'TXSATSTD', 'North Hills Family Medicine', 'Shahed "Sky"', '', 'Izaddoost', 'MD', 'Pediatrics', '', '', NULL, 'O', '11212 State Hwy 151 Bldg 2, Ste 201', 'San Antonio', 'Bexar', 'TX', '78251', '2106815747', '2106817515', '11212 State Hwy 151 Bldg 2, Ste 201', 'San Antonio', 'Bexar', 'TX', '78251', '2106815747', '2106817515', 'SANANTONIO1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1386928562', 0, 'N', 0, '2013-01-07', NULL, NULL, 29.4801, -98.7053, NULL, NULL),
('538081436', 'W12027324', 'W12027324', 'UT01', 'Panah Chiropractic', 'Ryan', 'Lee', 'Emmett', 'DC', 'Chiropractic', '', '', NULL, 'O', '2002 N Main St Ste 7', 'Cedar City', 'Iron', 'UT', '84721', '4358674505', '          ', '2002 N Main St Ste 7', 'Cedar City', 'Iron', 'UT', '84721', '4358674505', '          ', 'WLABRAD', 'WUSTDHCPC5', '', '0.00', '0.00', '57.12', 3, '2012-11-16', '2014-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1083837934', 0, 'N', 0, '2014-06-24', NULL, NULL, 37.7117, -113.061, 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
('800341115', 'W12027326', 'W12027326', 'UT01', 'Ulibarri Chiropractic and Rehab', 'Isaiah', '', 'Ulibarri', 'DC', 'Chiropractic', '', '', NULL, 'M', '6231 River Bluffs Rd', 'Salt Lake City', 'Salt Lake', 'UT', '84123', '8016743314', '8014163514', '6231 River Bluffs Rd', 'Salt Lake City', 'Salt Lake', 'UT', '84123', '8016743314', '8014163514', 'WLABRAD', 'WUSTDHCPC5', '', '0.00', '0.00', '57.12', 3, '2012-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194962621', 0, 'N', 0, '2013-12-06', NULL, NULL, 0, 0, NULL, NULL),
('205089251', 'W12027394', 'W12027394', 'UTMH1', 'Holistic Balance', 'Taffy Jo (TJ) ', '', 'Grow', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'O', '865 E 4800 S Ste 222', 'Murray', 'Salt Lake', 'UT', '84107', '8012662418', '8012663358', '865 E 4800 S Ste 222', 'Murray', 'Salt Lake', 'UT', '84107', '8012662418', '8012663358', 'UTMA', '', '', '0.00', '35.00', '0.00', 3, '2013-02-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316047848', 0, 'N', 0, '2013-02-06', NULL, NULL, 40.6654, -111.867, NULL, NULL),
('870399810', 'W12027328', 'W12027328', 'UT01', 'Noall H. Latimer R.P.T. Inc. P.C.', 'Noall', 'H', 'Latimer', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '3441 S 8400 W Ste F', 'Magna', 'Salt Lake', 'UT', '84044', '8012509107', '8012507840', '3441 S 8400 W Ste F', 'Magna', 'Salt Lake', 'UT', '84044', '8012509107', '8012507840', 'WESTREHAB', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2012-11-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1932167665', 0, 'N', 0, '2012-12-19', NULL, NULL, 40.6976, -112.092, NULL, NULL),
('810232125', 'W12027331', 'W12027331', 'UT01', 'Easter Seals Goodwill Northern Rocky Mountain Inc', 'Katharine', '', 'Street', 'OT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 2509', 'Great Falls', 'Cascade', 'MT', '59403', '8019461860', '8015825540', 'PO Box 2509', 'Great Falls', 'Cascade', 'MT', '59403', '8019461860', '8015825540', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2012-12-01', '2014-06-18', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356697205', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('061655757', 'W12027333', 'W12027333', 'UT01', 'MountainTop Physical Therapy & Wellness Center Inc', 'Heidi', 'C', 'Asbury-Wagner', 'DPT', 'Physical Therapy', '', '', NULL, 'O', '1794 Olympic Pkwy Ste 140', 'Park City', 'Summit', 'UT', '84098', '4355750345', '4355750346', '1794 Olympic Pkwy Ste 140', 'Park City', 'Summit', 'UT', '84098', '4355750345', '4355750346', 'WESTREHAB', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2012-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1932143609', 0, 'N', 0, '2012-12-19', NULL, NULL, 40.723, -111.48, NULL, NULL),
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('264333033', 'W12027471', 'W12027471', 'TXSATSTD', 'Institute for Womens Health', 'Joseph', 'R', 'Garza', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '18707 Hardy Oak Ste 500', 'San Antonio', 'Bexar', 'TX', '78258', '2106160680', '2106160684', '18707 Hardy Oak Ste 500', 'San Antonio', 'Bexar', 'TX', '78258', '2106160680', '2106160684', 'TXOBG', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-12-10', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1144210121', 0, 'N', 0, '2013-05-01', NULL, NULL, 29.6374, -98.4905, NULL, NULL),
('364088232', 'ELDR00001', 'ELDR00001', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'R', 'Nuyles', 'DO', 'Cardiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1003055179', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, 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
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('364088232', 'ELDR00003', 'ELDR00003', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'R', 'Nuyles', 'DO', 'Cardiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1003055179', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
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('364088232', 'ELDR00005', 'ELDR00005', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Nancy', 'E', 'Whereatt', 'MD', 'General Surgery', '', '', NULL, 'O', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1003829169', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00006', 'ELDR00006', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Nancy', 'E', 'Whereatt', 'MD', 'General Surgery', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1003829169', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
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('364088232', 'ELDR00008', 'ELDR00008', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sharon', 'C', 'Ollee', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1013076504', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
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('364088232', 'ELDR00013', 'ELDR00013', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Rosemary', '', 'Espinoza', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1013940238', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
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('364088232', 'ELDR00015', 'ELDR00015', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Brian', 'E', 'O Shaughnessy', 'MD', 'Neurology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1023021151', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00016', 'ELDR00016', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sandy', 'M', 'Kwak', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1033148291', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00017', 'ELDR00017', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sandy', 'M', 'Kwak', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6302648522', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1033148291', 0, 'Y', 0, '2014-04-17', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00018', 'ELDR00018', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sandy', 'M', 'Kwak', 'MD', 'Diagnostic Radiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1033148291', 0, 'Y', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00019', 'ELDR00019', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Anne', 'M', 'Kinn', 'DO', 'Hospitalist', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308593248', '          ', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308593248', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1053336073', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00020', 'ELDR00020', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Anne', 'M', 'Kinn', 'DO', 'Hospitalist', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1053336073', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00021', 'ELDR00021', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Verma', '', 'Priyadarshini', 'MD', 'Infectious Disease', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1053443895', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00022', 'ELDR00022', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Verma', '', 'Priyadarshini', 'MD', 'Infectious Disease', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1053443895', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00023', 'ELDR00023', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Keith', 'E', 'Benziger', 'MD', 'Pediatrics', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596744', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596744', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1073543112', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00024', 'ELDR00024', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Keith', 'E', 'Benziger', 'MD', 'Pediatrics', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1073543112', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00025', 'ELDR00025', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Linda', 'J', 'Hardie', 'AUD', 'Audiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648484', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648484', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1073618013', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00026', 'ELDR00026', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Linda', 'J', 'Hardie', 'AUD', 'Audiology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308597275', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308597275', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1073618013', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00027', 'ELDR00027', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Linda', 'J', 'Hardie', 'AUD', 'Audiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1073618013', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00028', 'ELDR00028', 'ILCHIGSTD', 'Dreyer Clinic', 'Silpa', '', 'Katta', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '2424 W Indian Trail Ste A', 'Aurora', 'Kane', 'IL', '60506', '6309071414', '6309071919', '2424 W Indian Trail Ste A', 'Aurora', 'Kane', 'IL', '60506', '6309071414', '6309071919', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083825392', 0, 'Y', 0, '2013-04-05', NULL, NULL, 41.7809, -88.3773, NULL, NULL),
('364088232', 'ELDR00029', 'ELDR00029', 'ILCHIGSTD', 'Dreyer Clinic', 'Silpa', '', 'Katta', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083825392', 0, 'Y', 0, '2013-04-05', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00030', 'ELDR00030', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Deslyn', 'S', 'Browne', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648864', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648864', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083827810', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00031', 'ELDR00031', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Deslyn', 'S', 'Browne', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924080', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924080', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083827810', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00033', 'ELDR00033', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Deslyn', 'S', 'Browne', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083827810', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00032', 'ELDR00032', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Deslyn', 'S', 'Browne', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512752', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512752', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083827810', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00034', 'ELDR00034', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Vivien', 'T', 'Ho', 'MD', 'Family Practice', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065941', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065941', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1083897888', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00035', 'ELDR00035', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Vivien', 'T', 'Ho', 'MD', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1083897888', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00036', 'ELDR00036', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Julianna', 'E', 'Eshbach', 'MD', 'Hospitalist', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308593248', '          ', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308593248', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093731770', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00037', 'ELDR00037', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Julianna', 'E', 'Eshbach', 'MD', 'Hospitalist', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093731770', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00039', 'ELDR00039', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Robert', 'J', 'Spelic', 'PAC', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104014653', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00038', 'ELDR00038', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Robert', 'J', 'Spelic', 'PAC', 'Family Practice', '', '', NULL, 'O', '741 East Lincoln Ave', 'Hinckley', 'Dekalb', 'IL', '60520', '8152869256', '8154394959', '741 East Lincoln Ave', 'Hinckley', 'Dekalb', 'IL', '60520', '8152869256', '8154394959', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104014653', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7694, -88.6301, NULL, NULL),
('364088232', 'ELDR00040', 'ELDR00040', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Thomas', 'C', 'White', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648423', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648423', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104813435', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00041', 'ELDR00041', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Thomas', 'C', 'White', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924129', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924129', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104813435', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00042', 'ELDR00042', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Thomas', 'C', 'White', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104813435', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00044', 'ELDR00044', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Mark', 'E', 'Peterson', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1114030384', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00043', 'ELDR00043', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Mark', 'E', 'Peterson', 'MD', 'Internal Medicine', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512933', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512933', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1114030384', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00045', 'ELDR00045', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'David', 'O', 'Zepeda', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1114036365', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00046', 'ELDR00046', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'David', 'O', 'Zepeda', 'MD', 'Gastroenterology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1114036365', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00047', 'ELDR00047', 'ILCHIGSTD', 'Dreyer Clinic', 'Julia', 'J', 'Choo', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648653', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648653', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114094042', 0, 'N', 0, '2014-01-16', NULL, NULL, 41.7828, -88.3276, NULL, NULL),
('364088232', 'ELDR00048', 'ELDR00048', 'ILCHIGSTD', 'Dreyer Clinic', 'Julia', 'J', 'Choo', 'MD', 'Radiation Oncology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114094042', 0, 'Y', 0, '2014-01-16', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00049', 'ELDR00049', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Rachna', '', 'Arora', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1114187200', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00050', 'ELDR00050', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Rachna', '', 'Arora', 'MD', 'Gastroenterology', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1114187200', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00051', 'ELDR00051', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Rachna', '', 'Arora', 'MD', 'Gastroenterology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1114187200', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00052', 'ELDR00052', 'ILCHIGSTD', 'Dreyer Clinic', 'Yasmin', 'K', 'Bhathena', 'MD', 'Pediatrics', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624723', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624723', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-10-27', 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1114953825', 0, 'N', 0, '2014-01-30', NULL, NULL, 41.8641, -88.3512, NULL, NULL),
('364088232', 'ELDR00053', 'ELDR00053', 'ILCHIGSTD', 'Dreyer Clinic', 'Yasmin', 'K', 'Bhathena', 'MD', 'Pediatrics', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786605', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786605', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2014-01-01', 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1114953825', 0, 'N', 0, '2014-01-30', NULL, NULL, 41.7524, -88.2148, NULL, NULL),
('364088232', 'ELDR00054', 'ELDR00054', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Yasmin', 'K', 'Bhathena', 'MD', 'Pediatrics', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1114953825', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00055', 'ELDR00055', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lindsay', 'S', 'Zucco', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124005095', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00056', 'ELDR00056', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lindsay', 'S', 'Zucco', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065099', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065099', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124005095', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00057', 'ELDR00057', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lindsay', 'S', 'Zucco', 'PT', 'Physical Therapy', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6304829200', '6307624774', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6304829200', '6307624774', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124005095', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00059', 'ELDR00059', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lindsay', 'S', 'Zucco', 'PT', 'Physical Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124005095', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00058', 'ELDR00058', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lindsay', 'S', 'Zucco', 'PT', 'Physical Therapy', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512740', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512740', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124005095', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00060', 'ELDR00060', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'R', 'Dantzer', 'MD', 'Pediatrics', '', '', NULL, 'O', '1500 Sycamore Rd', 'Yorkville', 'Kendall', 'IL', '60560', '6305534470', '6303017616', '1500 Sycamore Rd', 'Yorkville', 'Kendall', 'IL', '60560', '6305534470', '6303017616', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1124044474', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.6572, -88.4372, NULL, NULL),
('364088232', 'ELDR00061', 'ELDR00061', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'R', 'Dantzer', 'MD', 'Pediatrics', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1124044474', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00062', 'ELDR00062', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ernesto', 'A', 'Godoyna Romero', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1124051198', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00063', 'ELDR00063', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ernesto', 'A', 'Godoyna Romero', 'MD', 'Gastroenterology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1124051198', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00064', 'ELDR00064', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sara', 'J', 'Bealert', 'PAC', 'Allergy and Immunology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596796', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596796', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwestern Memorial Hospital', 'Presence Mercy Medical Center', NULL, NULL, 'HCFA|UB|', '1134115330', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00065', 'ELDR00065', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sara', 'J', 'Bealert', 'PAC', 'Allergy and Immunology', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786692', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786692', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwestern Memorial Hospital', 'Presence Mercy Medical Center', NULL, NULL, 'HCFA|UB|', '1134115330', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00066', 'ELDR00066', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sara', 'J', 'Bealert', 'PAC', 'Allergy and Immunology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwestern Memorial Hospital', 'Presence Mercy Medical Center', NULL, NULL, 'HCFA|UB|', '1134115330', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00067', 'ELDR00067', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Christian', 'S', 'Lopez', 'MD', 'Cardiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2014-04-30', 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1134369846', 0, 'N', 0, '2014-05-27', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00068', 'ELDR00068', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Christian', 'S', 'Lopez', 'MD', 'Cardiology', '', '', NULL, 'O', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924005', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924005', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2014-04-30', 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1134369846', 0, 'N', 0, '2014-05-27', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00069', 'ELDR00069', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Christian', 'S', 'Lopez', 'MD', 'Cardiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2014-04-30', 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1134369846', 0, 'Y', 0, '2014-05-27', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00070', 'ELDR00070', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Dominic', 'K', 'Leung', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144230335', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00071', 'ELDR00071', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Dominic', 'K', 'Leung', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144230335', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00072', 'ELDR00072', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ramona', 'K', 'Kitching', 'PAC', 'Family Practice', '', '', NULL, 'O', '2424 W Indian Trail Ste B', 'Aurora', 'Kane', 'IL', '60506', '6309072424', '6309072444', '2424 W Indian Trail Ste B', 'Aurora', 'Kane', 'IL', '60506', '6309072424', '6309072444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2014-05-31', 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144238684', 0, 'Y', 0, '2014-06-04', NULL, NULL, 41.7809, -88.3766, NULL, NULL),
('364088232', 'ELDR00074', 'ELDR00074', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ramona', 'K', 'Kitching', 'PAC', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2014-07-05', 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144238684', 0, 'Y', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00073', 'ELDR00073', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ramona', 'K', 'Kitching', 'PAC', 'Family Practice', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2014-07-05', 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144238684', 0, 'Y', 0, '2014-07-18', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00075', 'ELDR00075', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Matthew', 'P', 'Evans', 'MD', 'Dermatology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065970', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065970', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1144246828', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00076', 'ELDR00076', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Matthew', 'P', 'Evans', 'MD', 'Dermatology', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786694', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786694', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1144246828', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00077', 'ELDR00077', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Matthew', 'P', 'Evans', 'MD', 'Dermatology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1144246828', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00078', 'ELDR00078', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Misty', 'M', 'Otte', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144325770', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00079', 'ELDR00079', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Misty', 'M', 'Otte', 'PT', 'Physical Therapy', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6304829200', '6307624774', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6304829200', '6307624774', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144325770', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00080', 'ELDR00080', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Misty', 'M', 'Otte', 'PT', 'Physical Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144325770', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00081', 'ELDR00081', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Basil', 'S', 'Hernandez', 'MD', 'Hospitalist', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308593248', '          ', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308593248', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144327602', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00082', 'ELDR00082', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Basil', 'S', 'Hernandez', 'MD', 'Hospitalist', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144327602', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00083', 'ELDR00083', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Tabatha', 'E', 'Greene', 'PsyD', 'Mental Health', 'Psychology', '', NULL, 'O', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144554510', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7618, -88.3621, NULL, NULL),
('364088232', 'ELDR00084', 'ELDR00084', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Tabatha', 'E', 'Greene', 'PsyD', 'Mental Health', 'Psychology', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144554510', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00085', 'ELDR00085', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'John', 'M', 'Plotke', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1154322857', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00086', 'ELDR00086', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'John', 'M', 'Plotke', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065962', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065962', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1154322857', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00087', 'ELDR00087', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'John', 'M', 'Plotke', 'MD', 'Diagnostic Radiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1154322857', 0, 'Y', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00088', 'ELDR00088', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Katherine', 'M', 'Snyder', 'RDLD', 'Dietician', '', '', NULL, 'O', '1500 Sycamore Rd', 'Yorkville', 'Kendall', 'IL', '60560', '6305534470', '6303017616', '1500 Sycamore Rd', 'Yorkville', 'Kendall', 'IL', '60560', '6305534470', '6303017616', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1174531552', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.6572, -88.4372, NULL, NULL),
('364088232', 'ELDR00089', 'ELDR00089', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Katherine', 'M', 'Snyder', 'RDLD', 'Dietician', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596769', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596769', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1174531552', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00090', 'ELDR00090', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Katherine', 'M', 'Snyder', 'RDLD', 'Dietician', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1174531552', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00091', 'ELDR00091', 'ILCHIGSTD', 'Dreyer Clinic', 'Pamela', 'J', 'Schulz', 'DO', 'Pediatrics', '', '', NULL, 'O', '24508 W Village Ctr Dr', 'Plainfield', 'Will', 'IL', '60544', '8154399400', '8154394959', '24508 W Village Ctr Dr', 'Plainfield', 'Will', 'IL', '60544', '8154399400', '8154394959', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-07-22', 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', '', 'HCFA|UB|', '1174625206', 0, 'N', 0, '2013-07-23', NULL, NULL, 41.6072, -88.2151, 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
('364088232', 'ELDR00093', 'ELDR00093', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Pamela', 'J', 'Schulz', 'DO', 'Pediatrics', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', '', 'HCFA|UB|', '1174625206', 0, 'Y', 0, '2013-07-23', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00092', 'ELDR00092', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Pamela', 'J', 'Schulz', 'DO', 'Pediatrics', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512810', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512810', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', '', 'HCFA|UB|', '1174625206', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00094', 'ELDR00094', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Kalliope', 'M', 'Morrell', 'APN', 'Internal Medicine', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065941', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065941', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174874853', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00095', 'ELDR00095', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Kalliope', 'M', 'Morrell', 'APN', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174874853', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00096', 'ELDR00096', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Keith', 'E', 'Weiler', 'MD', 'Family Practice', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1184733321', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00097', 'ELDR00097', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Keith', 'E', 'Weiler', 'MD', 'Family Practice', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1184733321', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00098', 'ELDR00098', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Keith', 'E', 'Weiler', 'MD', 'Family Practice', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1184733321', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00099', 'ELDR00099', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Keith', 'E', 'Weiler', 'MD', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1184733321', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00100', 'ELDR00100', 'ILCHIGSTD', 'Dreyer Clinic', 'Bharthi', 'B', 'Rao', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624821', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624821', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194714873', 0, 'Y', 0, '2013-08-14', NULL, NULL, 41.8641, -88.3512, NULL, NULL),
('364088232', 'ELDR00101', 'ELDR00101', 'ILCHIGSTD', 'Dreyer Clinic', 'Bharthi', 'B', 'Rao', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194714873', 0, 'Y', 0, '2013-08-14', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00102', 'ELDR00102', 'ILCHIGSTD', 'Dreyer Clinic', 'Cornelius', 'K', 'Smith', 'MD', 'Urology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194741298', 0, 'N', 0, '2014-01-16', NULL, NULL, 41.7828, -88.3276, NULL, NULL),
('364088232', 'ELDR00103', 'ELDR00103', 'ILCHIGSTD', 'Dreyer Clinic', 'Cornelius', 'K', 'Smith', 'MD', 'Urology', '', '', NULL, 'O', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194741298', 0, 'N', 0, '2014-01-16', NULL, NULL, 41.7291, -88.2664, NULL, NULL),
('364088232', 'ELDR00104', 'ELDR00104', 'ILCHIGSTD', 'Dreyer Clinic', 'Cornelius', 'K', 'Smith', 'MD', 'Urology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194741298', 0, 'Y', 0, '2014-01-16', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00105', 'ELDR00105', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Mark', 'J', 'Bowman', 'DO', 'Family Practice', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1194750075', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00106', 'ELDR00106', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Mark', 'J', 'Bowman', 'DO', 'Family Practice', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1194750075', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00107', 'ELDR00107', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Mark', 'J', 'Bowman', 'DO', 'Family Practice', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1194750075', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00108', 'ELDR00108', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Mark', 'J', 'Bowman', 'DO', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1194750075', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00109', 'ELDR00109', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jaweed', '', 'Sayeed', 'MD', 'Cardiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1194772780', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00110', 'ELDR00110', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jaweed', '', 'Sayeed', 'MD', 'Cardiology', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924005', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924005', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1194772780', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00111', 'ELDR00111', 'ILCHIGSTD', 'Dreyer MedicalClinic', 'Jaweed', '', 'Sayeed', 'MD', 'Cardiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1194772780', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00112', 'ELDR00112', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Randall', 'E', 'Bennett', 'LCPC LMFT', 'Mental Health', 'Counseling', '', NULL, 'O', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1194835702', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7618, -88.3621, NULL, NULL),
('364088232', 'ELDR00113', 'ELDR00113', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Randall', 'E', 'Bennett', 'LCPC LMFT', 'Mental Health', 'Counseling', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1194835702', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00114', 'ELDR00114', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sonia', '', 'Sharma', 'DO', 'Hospitalist', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308593248', '          ', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308593248', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194981563', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00115', 'ELDR00115', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sonia', '', 'Sharma', 'DO', 'Hospitalist', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194981563', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00116', 'ELDR00116', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Salitha', '', 'Reddy', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648653', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648653', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1205844958', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00117', 'ELDR00117', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Salitha', '', 'Reddy', 'MD', 'Radiation Oncology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1205844958', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00118', 'ELDR00118', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'F', 'Marzec', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1205847613', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00119', 'ELDR00119', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'F', 'Marzec', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1205847613', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00120', 'ELDR00120', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'David', 'L', 'Gibson', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1225030927', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00121', 'ELDR00121', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'David', 'L', 'Gibson', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6302648522', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1225030927', 0, 'Y', 0, '2014-04-17', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00122', 'ELDR00122', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'David', 'L', 'Gibson', 'MD', 'Diagnostic Radiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1225030927', 0, 'Y', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00124', 'ELDR00124', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Marie', 'E', 'Garcia', 'PT', 'Physical Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225133242', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00123', 'ELDR00123', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Marie', 'E', 'Garcia', 'PT', 'Physical Therapy', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512764', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512764', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225133242', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00125', 'ELDR00125', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Andrei', 'V', 'Pankov', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225285703', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7618, -88.3621, NULL, NULL),
('364088232', 'ELDR00126', 'ELDR00126', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Andrei', 'V', 'Pankov', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786694', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786694', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225285703', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00127', 'ELDR00127', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Andrei', 'V', 'Pankov', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225285703', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00128', 'ELDR00128', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Earl Phillip', '', 'Ow', 'MD', 'Pediatric Cardiology', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786692', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786692', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235110958', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00129', 'ELDR00129', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Earl Phillip', '', 'Ow', 'MD', 'Pediatric Cardiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235110958', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00130', 'ELDR00130', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Robert', 'G', 'Ireland', 'DO', 'Family Practice', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1235154337', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00131', 'ELDR00131', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Robert', 'G', 'Ireland', 'DO', 'Family Practice', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1235154337', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00132', 'ELDR00132', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Robert', 'G', 'Ireland', 'DO', 'Family Practice', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1235154337', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00133', 'ELDR00133', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Robert', 'G', 'Ireland', 'DO', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1235154337', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00134', 'ELDR00134', 'ILCHIGSTD', 'Dreyer Clinic', 'Charlene', 'R', 'Brown', 'MD', 'Pediatric Psychiatry', '', '', NULL, 'O', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235257718', 0, 'Y', 0, '2013-07-09', NULL, NULL, 41.7623, -88.3603, NULL, NULL),
('364088232', 'ELDR00135', 'ELDR00135', 'ILCHIGSTD', 'Dreyer Clinic', 'Charlene', 'R', 'Brown', 'MD', 'Pediatric Psychiatry', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235257718', 0, 'Y', 0, '2013-07-09', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00137', 'ELDR00137', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Karen', 'J', 'Chorvat', 'MD', 'Pediatrics', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1245402932', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00136', 'ELDR00136', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Karen', 'J', 'Chorvat', 'MD', 'Pediatrics', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512810', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512810', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1245402932', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00138', 'ELDR00138', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Kristen', 'M', 'Cosgrove Counts', 'MD', 'Family Practice', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065941', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065941', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255393732', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00139', 'ELDR00139', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Kristen', 'M', 'Cosgrove Counts', 'MD', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255393732', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00140', 'ELDR00140', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jill', 'M', 'Taylor', 'PAC', 'Family Practice', '', '', NULL, 'O', '1500 Sycamore Rd', 'Yorkville', 'Kendall', 'IL', '60560', '6305534470', '6303017616', '1500 Sycamore Rd', 'Yorkville', 'Kendall', 'IL', '60560', '6305534470', '6303017616', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1265460224', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.6572, -88.4372, NULL, NULL),
('364088232', 'ELDR00141', 'ELDR00141', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jill', 'M', 'Taylor', 'PAC', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1265460224', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00142', 'ELDR00142', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Neha', 'M', 'Adatia', 'DO', 'Hospitalist', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308593248', '          ', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308593248', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265698781', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00143', 'ELDR00143', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Neha', 'M', 'Adatia', 'DO', 'Hospitalist', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265698781', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00144', 'ELDR00144', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Suveer', 'B', 'Tatineni', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1275579401', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00145', 'ELDR00145', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Suveer', 'B', 'Tatineni', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065962', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065962', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1275579401', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00146', 'ELDR00146', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Suveer', 'B', 'Tatineni', 'MD', 'Diagnostic Radiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1275579401', 0, 'Y', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
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('364088232', 'ELDR00148', 'ELDR00148', 'ILCHIGSTD', 'Dreyer Clinic', 'Donald', 'P', 'Prentiss', 'MD', 'General Surgery', '', '', NULL, 'O', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-11-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275617839', 0, 'N', 0, '2013-12-03', NULL, NULL, 41.7291, -88.2664, NULL, NULL),
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('364088232', 'ELDR00164', 'ELDR00164', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Rachel', 'L', 'Bohringer', 'PT', 'Physical Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1285828301', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00163', 'ELDR00163', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Rachel', 'L', 'Bohringer', 'PT', 'Physical Therapy', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512764', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512764', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1285828301', 0, 'Y', 0, '2014-04-04', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00165', 'ELDR00165', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'David', 'B', 'Wallace', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1295736809', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
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('364088232', 'ELDR00169', 'ELDR00169', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Edwin', 'H', 'Dolin', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6302648522', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1295737195', 0, 'Y', 0, '2014-04-17', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00170', 'ELDR00170', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Edwin', 'H', 'Dolin', 'MD', 'Diagnostic Radiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1295737195', 0, 'Y', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
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('364088232', 'ELDR00172', 'ELDR00172', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lisa', 'A', 'Groskopf', 'DO', 'Hospitalist', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1295753689', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
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('364088232', 'ELDR00174', 'ELDR00174', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Prasun', 'K', 'Das', 'MD', 'Internal Medicine', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1295768778', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00175', 'ELDR00175', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Prasun', 'K', 'Das', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1295768778', 0, 'N', 0, '2014-04-04', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00176', 'ELDR00176', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Prasun', 'K', 'Das', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1295768778', 0, 'Y', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
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('364088232', 'ELDR00179', 'ELDR00179', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Adam', 'D', 'Stein', 'MD', 'Endocrinology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1316003833', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00180', 'ELDR00180', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Adam', 'D', 'Stein', 'MD', 'Endocrinology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1316003833', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00181', 'ELDR00181', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Amanda', 'A', 'Szelc', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1316131444', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00183', 'ELDR00183', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Amanda', 'A', 'Szelc', 'PT', 'Physical Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1316131444', 0, 'Y', 0, '2012-12-19', 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
('364088232', 'ELDR00182', 'ELDR00182', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Amanda', 'A', 'Szelc', 'PT', 'Physical Therapy', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512764', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512764', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1316131444', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00184', 'ELDR00184', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Tanya', 'K', 'Bulj', 'MD', 'Dermatology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065970', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065970', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1316144892', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00185', 'ELDR00185', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Tanya', 'K', 'Bulj', 'MD', 'Dermatology', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6304829200', '6307624821', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6304829200', '6307624821', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1316144892', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00186', 'ELDR00186', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Tanya', 'K', 'Bulj', 'MD', 'Dermatology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1316144892', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00187', 'ELDR00187', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Candy', 'M', 'Schilf', 'APN', 'Family Practice', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065941', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065941', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1316940737', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00188', 'ELDR00188', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Candy', 'M', 'Schilf', 'APN', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1316940737', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00189', 'ELDR00189', 'ILCHIGSTD', 'Dreyer Clinic', 'Brian', 'D', 'Oostman', 'DO', 'Family Practice', '', '', NULL, 'O', '2424 W Indian Trail Ste A', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6309071919', '2424 W Indian Trail Ste A', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6309071919', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2014-02-28', 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1316950496', 0, 'N', 0, '2014-03-13', NULL, NULL, 41.7809, -88.3766, NULL, NULL),
('364088232', 'ELDR00191', 'ELDR00191', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Brian', 'D', 'Oostman', 'DO', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1316950496', 0, 'N', 0, '2014-03-13', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00190', 'ELDR00190', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Brian', 'D', 'Oostman', 'DO', 'Family Practice', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1316950496', 0, 'N', 0, '2013-05-01', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00192', 'ELDR00192', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jeffrey', 'D', 'Sroka', 'MD', 'Pediatrics', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307627830', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307627830', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1316962012', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00193', 'ELDR00193', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jeffrey', 'D', 'Sroka', 'MD', 'Pediatrics', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1316962012', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00194', 'ELDR00194', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Titus', '', 'Chang', 'MD', 'Allergy and Immunology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596796', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596796', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', '', 'HCFA|UB|', '1316988850', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00195', 'ELDR00195', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Titus', '', 'Chang', 'MD', 'Allergy and Immunology', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786692', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786692', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', '', 'HCFA|UB|', '1316988850', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00196', 'ELDR00196', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Titus', '', 'Chang', 'MD', 'Allergy and Immunology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', '', 'HCFA|UB|', '1316988850', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00197', 'ELDR00197', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Alexander', 'S', 'Kedzierski', 'DO', 'Family Practice', '', '', NULL, 'O', '24508 W Village Ctr Dr', 'Plainfield', 'Will', 'IL', '60544', '8154399400', '8154394959', '24508 W Village Ctr Dr', 'Plainfield', 'Will', 'IL', '60544', '8154399400', '8154394959', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326006610', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.6073, -88.2148, NULL, NULL),
('364088232', 'ELDR00198', 'ELDR00198', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Alexander', 'S', 'Kedzierski', 'DO', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326006610', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00199', 'ELDR00199', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Adam', 'N', 'Blonsky', 'MD', 'Internal Medicine', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624779', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624779', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1326055294', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00200', 'ELDR00200', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Adam', 'N', 'Blonsky', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1326055294', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00201', 'ELDR00201', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jon', 'R', 'Doud', 'MD', 'Pulmonary', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326077678', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00202', 'ELDR00202', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jon', 'R', 'Doud', 'MD', 'Pulmonary', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326077678', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00203', 'ELDR00203', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Stephanie', 'R', 'Beetham  Schramer ', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1336313352', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00204', 'ELDR00204', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Stephanie', 'R', 'Beetham  Schramer ', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065099', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065099', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1336313352', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00205', 'ELDR00205', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Stephanie', 'R', 'Beetham  Schramer ', 'PT', 'Physical Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1336313352', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00207', 'ELDR00207', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Alexis', 'P', 'Dunne', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1336324367', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00206', 'ELDR00206', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Alexis', 'P', 'Dunne', 'MD', 'Internal Medicine', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512933', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512933', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1336324367', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00208', 'ELDR00208', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Charles', 'R', 'Ireland', 'DO', 'Family Practice', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1346268604', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00209', 'ELDR00209', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Charles', 'R', 'Ireland', 'DO', 'Family Practice', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1346268604', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00210', 'ELDR00210', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Charles', 'R', 'Ireland', 'DO', 'Family Practice', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1346268604', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00211', 'ELDR00211', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Charles', 'R', 'Ireland', 'DO', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1346268604', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00212', 'ELDR00212', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Maria', 'T', 'Arzadonna Mercado', 'APN', 'Internal Medicine', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1356448872', 0, 'Y', 0, '2013-04-17', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00213', 'ELDR00213', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Maria', 'T', 'Arzadonna Mercado', 'APN', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1356448872', 0, 'Y', 0, '2013-04-17', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00214', 'ELDR00214', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', '', 'Collins', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1366467680', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00215', 'ELDR00215', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', '', 'Collins', 'MD', 'Internal Medicine', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1366467680', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00216', 'ELDR00216', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', '', 'Collins', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1366467680', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00217', 'ELDR00217', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', '', 'Collins', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1366467680', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00219', 'ELDR00219', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sharon', 'L', 'Shieh', 'PAC', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366563280', 0, 'Y', 0, '2013-04-17', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00218', 'ELDR00218', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sharon', 'L', 'Shieh', 'PAC', 'Internal Medicine', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512933', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512933', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366563280', 0, 'Y', 0, '2013-04-17', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00220', 'ELDR00220', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Roman', '', 'Dreyer', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786692', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786692', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1376576793', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00221', 'ELDR00221', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Roman', '', 'Dreyer', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1376576793', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00222', 'ELDR00222', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'J', 'Hutchinson', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1376707513', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00223', 'ELDR00223', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'J', 'Hutchinson', 'MD', 'Diagnostic Radiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1376707513', 0, 'Y', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00224', 'ELDR00224', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Christopher', 'A', 'Lading', 'SLP', 'Speech Therapy', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596744', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596744', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376787838', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00225', 'ELDR00225', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Christopher', 'A', 'Lading', 'SLP', 'Speech Therapy', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60506', '6308792110', '6307624723', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60506', '6308792110', '6307624723', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376787838', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00226', 'ELDR00226', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Christopher', 'A', 'Lading', 'SLP', 'Speech Therapy', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786605', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786605', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376787838', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00228', 'ELDR00228', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Christopher', 'A', 'Lading', 'SLP', 'Speech Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376787838', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00227', 'ELDR00227', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Christopher', 'A', 'Lading', 'SLP', 'Speech Therapy', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512810', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512810', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376787838', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00229', 'ELDR00229', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Bonnie', 'J', 'Meyer', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386740728', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00231', 'ELDR00231', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Bonnie', 'J', 'Meyer', 'PT', 'Physical Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386740728', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00230', 'ELDR00230', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Bonnie', 'J', 'Meyer', 'PT', 'Physical Therapy', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512764', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512764', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386740728', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00233', 'ELDR00233', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sandra', 'T', 'Labak', 'DO', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1396766218', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00232', 'ELDR00232', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sandra', 'T', 'Labak', 'DO', 'Family Practice', '', '', NULL, 'O', '741 East Lincoln Ave', 'Hinckley', 'Dekalb', 'IL', '60520', '8152869256', '8154394959', '741 East Lincoln Ave', 'Hinckley', 'Dekalb', 'IL', '60520', '8152869256', '8154394959', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1396766218', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7694, -88.6301, NULL, NULL),
('364088232', 'ELDR00234', 'ELDR00234', 'ILCHIGSTD', 'Dreyer Clinic', 'Patricia', 'J', 'Valassis', 'MD', 'Pediatrics', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786605', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786605', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1407012743', 0, 'N', 0, '2013-04-05', NULL, NULL, 41.7524, -88.2148, NULL, NULL),
('364088232', 'ELDR00235', 'ELDR00235', 'ILCHIGSTD', 'Dreyer Clinic', 'Patricia', 'J', 'Valassis', 'MD', 'Pediatrics', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1407012743', 0, 'Y', 0, '2013-04-05', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00236', 'ELDR00236', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Samuel', 'H', 'Eaton', 'MD', 'Urology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1407026479', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00237', 'ELDR00237', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Samuel', 'H', 'Eaton', 'MD', 'Urology', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1407026479', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00238', 'ELDR00238', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Samuel', 'H', 'Eaton', 'MD', 'Urology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1407026479', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00239', 'ELDR00239', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Nancy', 'E', 'Rifenburg', 'MD', 'Radiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407049778', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00240', 'ELDR00240', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Nancy', 'E', 'Rifenburg', 'MD', 'Radiology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065962', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065962', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407049778', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00241', 'ELDR00241', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Nancy', 'E', 'Rifenburg', 'MD', 'Radiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407049778', 0, 'Y', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00242', 'ELDR00242', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Richard', 'W', 'Puls', 'MD', 'Family Practice', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1407818230', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00243', 'ELDR00243', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Richard', 'W', 'Puls', 'MD', 'Family Practice', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1407818230', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00244', 'ELDR00244', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Richard', 'W', 'Puls', 'MD', 'Family Practice', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1407818230', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00245', 'ELDR00245', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Richard', 'W', 'Puls', 'MD', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1407818230', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00246', 'ELDR00246', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'James', 'D', 'Studlo', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1407857105', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00247', 'ELDR00247', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'James', 'D', 'Studlo', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065962', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065962', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1407857105', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00248', 'ELDR00248', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'James', 'D', 'Studlo', 'MD', 'Diagnostic Radiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1407857105', 0, 'Y', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00249', 'ELDR00249', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Bernard', 'G', 'Schupbach', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1407857287', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00250', 'ELDR00250', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Bernard', 'G', 'Schupbach', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065962', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065962', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1407857287', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00251', 'ELDR00251', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Bernard', 'G', 'Schupbach', 'MD', 'Diagnostic Radiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1407857287', 0, 'Y', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00252', 'ELDR00252', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Karen', 'M', 'Lee', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786669', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786669', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1417022351', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00253', 'ELDR00253', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Karen', 'M', 'Lee', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1417022351', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00254', 'ELDR00254', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Farah', 'K', 'Hussain', 'DO', 'Cardiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417076449', 0, 'N', 0, '2013-04-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00255', 'ELDR00255', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Farah', 'K', 'Hussain', 'DO', 'Cardiology', '', '', NULL, 'O', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924005', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924005', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417076449', 0, 'N', 0, '2013-04-04', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00256', 'ELDR00256', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Farah', 'K', 'Hussain', 'DO', 'Cardiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417076449', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00257', 'ELDR00257', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sarah', '', 'Nadeem', 'MD', 'Endocrinology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1427266212', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00258', 'ELDR00258', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sarah', '', 'Nadeem', 'MD', 'Endocrinology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1427266212', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00259', 'ELDR00259', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Bina', 'I', 'Mirza', 'MD', 'Nephrology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1437158334', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00260', 'ELDR00260', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Bina', 'I', 'Mirza', 'MD', 'Nephrology', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kendall', 'IL', '60560', '6308792110', '6307624779', '2500 W Fabyan Pkwy', 'Batavia', 'Kendall', 'IL', '60560', '6308792110', '6307624779', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1437158334', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00261', 'ELDR00261', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Bina', 'I', 'Mirza', 'MD', 'Nephrology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1437158334', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00262', 'ELDR00262', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jose', '', 'Magana', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447261847', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00263', 'ELDR00263', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jose', '', 'Magana', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447261847', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00264', 'ELDR00264', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ashok', 'A', 'Jagasia', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648484', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648484', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447278676', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00265', 'ELDR00265', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ashok', 'A', 'Jagasia', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924057', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924057', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447278676', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00266', 'ELDR00266', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ashok', 'A', 'Jagasia', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447278676', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00267', 'ELDR00267', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jignasa', 'M', 'Puri', 'DO', 'Family Practice', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447283908', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00268', 'ELDR00268', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jignasa', 'M', 'Puri', 'DO', 'Family Practice', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447283908', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00269', 'ELDR00269', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jignasa', 'M', 'Puri', 'DO', 'Family Practice', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447283908', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00270', 'ELDR00270', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jignasa', 'M', 'Puri', 'DO', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447283908', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00271', 'ELDR00271', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Brian', 'T', 'Hubbard', 'DO', 'Family Practice', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447284476', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00272', 'ELDR00272', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Brian', 'T', 'Hubbard', 'DO', 'Family Practice', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447284476', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00273', 'ELDR00273', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Brian', 'T', 'Hubbard', 'DO', 'Family Practice', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447284476', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, 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
('364088232', 'ELDR00274', 'ELDR00274', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Brian', 'T', 'Hubbard', 'DO', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447284476', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00275', 'ELDR00275', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Laurie', 'R', 'Schnell', 'MD', 'Pediatrics', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596744', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596744', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1447364211', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00276', 'ELDR00276', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Laurie', 'R', 'Schnell', 'MD', 'Pediatrics', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1447364211', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00277', 'ELDR00277', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Nicholas', 'D', 'Kennedy', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1447416235', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00278', 'ELDR00278', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Nicholas', 'D', 'Kennedy', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '8302648522', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '8302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1447416235', 0, 'Y', 0, '2014-04-17', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
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('364088232', 'ELDR00295', 'ELDR00295', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Alice', 'B', 'Daniele', 'MD', 'Hospitalist', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1477579712', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
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('364088232', 'ELDR00304', 'ELDR00304', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Richard', 'L', 'Kersch', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1487689600', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
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('364088232', 'ELDR00310', 'ELDR00310', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ibrahim', 'A', 'Taha', 'DPM', 'Podiatry', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648423', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648423', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1487763678', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00311', 'ELDR00311', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ibrahim', 'A', 'Taha', 'DPM', 'Podiatry', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1487763678', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00312', 'ELDR00312', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Shawn', 'R', 'Lapetino', 'MD', 'Pathology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648478', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648478', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1487817607', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00313', 'ELDR00313', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Shawn', 'R', 'Lapetino', 'MD', 'Pathology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1487817607', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00314', 'ELDR00314', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sarah', 'A', 'Cauldwell Bratt', 'APN', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648864', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648864', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497917470', 0, 'Y', 0, '2013-04-17', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00315', 'ELDR00315', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sarah', 'A', 'Cauldwell Bratt', 'APN', 'Obstetrics and Gynecology', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924080', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924080', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497917470', 0, 'Y', 0, '2013-04-17', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00316', 'ELDR00316', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sarah', 'A', 'Cauldwell Bratt', 'APN', 'Obstetrics and Gynecology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497917470', 0, 'Y', 0, '2013-04-17', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00317', 'ELDR00317', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sameer', 'M', 'Mazhar', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1497932461', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00318', 'ELDR00318', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sameer', 'M', 'Mazhar', 'MD', 'Gastroenterology', '', '', NULL, 'O', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1497932461', 0, 'N', 0, '2013-04-04', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00319', 'ELDR00319', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sameer', 'M', 'Mazhar', 'MD', 'Gastroenterology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1497932461', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00320', 'ELDR00320', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Brendan', 'M', 'Thomas', 'MD', 'Dermatology', '', '', NULL, 'O', '1500 Sycamore Rd', 'Yorkville', 'Kendall', 'IL', '60560', '6305534470', '6303017616', '1500 Sycamore Rd', 'Yorkville', 'Kendall', 'IL', '60560', '6305534470', '6303017616', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2014-07-01', 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1497989644', 0, 'N', 0, '2014-06-24', NULL, NULL, 41.6572, -88.4372, NULL, NULL),
('364088232', 'ELDR00321', 'ELDR00321', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Brendan', 'M', 'Thomas', 'MD', 'Dermatology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065970', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065970', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1497989644', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00322', 'ELDR00322', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Brendan', 'M', 'Thomas', 'MD', 'Dermatology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1497989644', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00323', 'ELDR00323', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Nicholas', 'T', 'Romano', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508171166', 0, 'Y', 0, '2013-11-14', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00324', 'ELDR00324', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Nicholas', 'T', 'Romano', 'PT', 'Physical Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508171166', 0, 'Y', 0, '2013-11-14', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00325', 'ELDR00325', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Dave', 'Y', 'Chua', 'MD', 'Cardiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1508807280', 0, 'N', 0, '2013-10-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00326', 'ELDR00326', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Dave', 'Y', 'Chua', 'MD', 'Cardiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1508807280', 0, 'Y', 0, '2013-10-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00327', 'ELDR00327', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Renee', 'A', 'Souba', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308597275', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308597275', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1508976937', 0, 'Y', 0, '2013-04-22', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00328', 'ELDR00328', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Renee', 'A', 'Souba', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1508976937', 0, 'Y', 0, '2013-04-22', NULL, NULL, 41.7618, -88.3621, NULL, NULL),
('364088232', 'ELDR00329', 'ELDR00329', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Renee', 'A', 'Souba', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1508976937', 0, 'Y', 0, '2013-04-22', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00330', 'ELDR00330', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Steven', 'J', 'Sapyta', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1500 Sycamore Rd', 'Yorkville', 'Kendall', 'IL', '60560', '6305534470', '6303017616', '1500 Sycamore Rd', 'Yorkville', 'Kendall', 'IL', '60560', '6305534470', '6303017616', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1518071323', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.6572, -88.4372, NULL, NULL),
('364088232', 'ELDR00331', 'ELDR00331', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Steven', 'J', 'Sapyta', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1518071323', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00332', 'ELDR00332', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Steven', 'J', 'Sapyta', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1518071323', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00334', 'ELDR00334', 'ILCHIGSTD', 'Dreyer Clinic', 'Christen', 'A', 'Tibbs', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518123363', 0, 'Y', 0, '2013-11-18', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00333', 'ELDR00333', 'ILCHIGSTD', 'Dreyer Clinic', 'Christen', 'A', 'Tibbs', 'MD', 'Internal Medicine', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518123363', 0, 'N', 0, '2013-11-18', NULL, NULL, 41.6735, -88.343, NULL, NULL),
('364088232', 'ELDR00335', 'ELDR00335', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'J', 'Radtke', 'MD', 'Allergy and Immunology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596796', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596796', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1518141365', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00336', 'ELDR00336', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'J', 'Radtke', 'MD', 'Allergy and Immunology', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786692', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786692', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1518141365', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00337', 'ELDR00337', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'J', 'Radtke', 'MD', 'Allergy and Immunology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1518141365', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00338', 'ELDR00338', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jeffrey', 'R', 'Schiltz', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528116050', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00339', 'ELDR00339', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jeffrey', 'R', 'Schiltz', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065099', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065099', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528116050', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00340', 'ELDR00340', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jeffrey', 'R', 'Schiltz', 'PT', 'Physical Therapy', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6304829200', '6307624774', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6304829200', '6307624774', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528116050', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00342', 'ELDR00342', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jeffrey', 'R', 'Schiltz', 'PT', 'Physical Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528116050', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00341', 'ELDR00341', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jeffrey', 'R', 'Schiltz', 'PT', 'Physical Therapy', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512764', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512764', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528116050', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00343', 'ELDR00343', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Guoshi', 'C', 'Zhang', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528164829', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7618, -88.3621, NULL, NULL),
('364088232', 'ELDR00344', 'ELDR00344', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Guoshi', 'C', 'Zhang', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528164829', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00345', 'ELDR00345', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jennifer', 'K', 'Yin', 'MD', 'Hospitalist', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308593248', NULL, '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308593248', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528224169', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00346', 'ELDR00346', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jennifer', 'K', 'Yin', 'MD', 'Hospitalist', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528224169', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00348', 'ELDR00348', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Melissa', 'K', 'Best', 'PAC', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1538109947', 0, 'Y', 0, '2013-04-17', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00347', 'ELDR00347', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Melissa', 'K', 'Best', 'PAC', 'Family Practice', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1538109947', 0, 'Y', 0, '2013-04-17', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00349', 'ELDR00349', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sunil', 'K', 'Malkani', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786692', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786692', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1538153655', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00350', 'ELDR00350', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sunil', 'K', 'Malkani', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1538153655', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00351', 'ELDR00351', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lutoria', '', 'Riechers', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065099', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065099', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538359773', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00352', 'ELDR00352', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lutoria', '', 'Riechers', 'PT', 'Physical Therapy', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6304829200', '6307624774', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6304829200', '6307624774', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538359773', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00354', 'ELDR00354', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lutoria', '', 'Riechers', 'PT', 'Physical Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538359773', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00353', 'ELDR00353', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lutoria', '', 'Riechers', 'PT', 'Physical Therapy', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512764', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512764', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538359773', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00355', 'ELDR00355', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'John', 'L', 'Chu', 'MD', 'Ophthalmology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648809', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648809', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548285844', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00356', 'ELDR00356', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'John', 'L', 'Chu', 'MD', 'Ophthalmology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548285844', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00357', 'ELDR00357', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lowell', 'D', 'Carpenter', 'MD', 'Cardiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548285992', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00358', 'ELDR00358', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lowell', 'D', 'Carpenter', 'MD', 'Cardiology', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924005', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924005', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548285992', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00359', 'ELDR00359', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lowell', 'D', 'Carpenter', 'MD', 'Cardiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548285992', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00360', 'ELDR00360', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Saba', 'B', 'Khan', 'MD', 'Pathology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648766', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648766', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548289994', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00361', 'ELDR00361', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Saba', 'B', 'Khan', 'MD', 'Pathology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548289994', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00362', 'ELDR00362', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Siddharth', 'A', 'Kakodkar', 'MD', 'Cardiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548306533', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00363', 'ELDR00363', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Siddharth', 'A', 'Kakodkar', 'MD', 'Cardiology', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924005', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924005', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548306533', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00364', 'ELDR00364', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Siddharth', 'A', 'Kakodkar', 'MD', 'Cardiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548306533', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00365', 'ELDR00365', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Kabhir', '', 'Julka', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548473143', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, 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
('364088232', 'ELDR00366', 'ELDR00366', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Kabhir', '', 'Julka', 'MD', 'Gastroenterology', '', '', NULL, 'O', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548473143', 0, 'N', 0, '2013-04-04', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00367', 'ELDR00367', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Kabhir', '', 'Julka', 'MD', 'Gastroenterology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548473143', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00368', 'ELDR00368', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Edward', 'J', 'Heinisch', 'OD', 'Optometry', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648809', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648809', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558394569', 0, 'N', 0, '2013-11-01', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00369', 'ELDR00369', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Edward', 'J', 'Heinisch', 'OD', 'Optometry', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558394569', 0, 'Y', 0, '2013-11-01', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00370', 'ELDR00370', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Mary', 'K', 'Formea', 'MS PT', 'Physical Therapy', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558467613', 0, 'Y', 0, '2013-08-13', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00371', 'ELDR00371', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Mary', 'K', 'Formea', 'MS PT', 'Physical Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558467613', 0, 'Y', 0, '2013-08-13', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00372', 'ELDR00372', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Madhulika', '', 'Char', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558467910', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00373', 'ELDR00373', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Madhulika', '', 'Char', 'PT', 'Physical Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558467910', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00374', 'ELDR00374', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Megan', 'A', 'Wojcik', 'SLP', 'Speech Therapy', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558522250', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00375', 'ELDR00375', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Megan', 'A', 'Wojcik', 'SLP', 'Speech Therapy', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596744', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596744', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558522250', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00376', 'ELDR00376', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Megan', 'A', 'Wojcik', 'SLP', 'Speech Therapy', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786605', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786605', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558522250', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
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('364088232', 'ELDR00408', 'ELDR00408', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Andrew', 'D', 'Jung', 'MD', 'Pediatrics', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624723', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624723', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1598814329', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00409', 'ELDR00409', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Andrew', 'D', 'Jung', 'MD', 'Pediatrics', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1598814329', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00410', 'ELDR00410', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'I', 'Rosenberg', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1598878068', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00411', 'ELDR00411', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'I', 'Rosenberg', 'MD', 'Gastroenterology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1598878068', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00412', 'ELDR00412', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Anthony', 'N', 'Williams', 'PAC', 'Orthopedic Surgery', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648423', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648423', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1598899700', 0, 'Y', 0, '2013-04-17', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00413', 'ELDR00413', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Anthony', 'N', 'Williams', 'PAC', 'Orthopedic Surgery', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924129', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924129', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1598899700', 0, 'Y', 0, '2013-04-17', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00414', 'ELDR00414', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Anthony', 'N', 'Williams', 'PAC', 'Orthopedic Surgery', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1598899700', 0, 'Y', 0, '2013-04-17', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00415', 'ELDR00415', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Huma', '', 'Abbas', 'MD', 'Pediatric Psychiatry', '', '', NULL, 'O', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609039163', 0, 'Y', 0, '2014-01-13', NULL, NULL, 41.7618, -88.3621, NULL, NULL),
('364088232', 'ELDR00416', 'ELDR00416', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Huma', '', 'Abbas', 'MD', 'Pediatric Psychiatry', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786694', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786694', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609039163', 0, 'Y', 0, '2014-01-13', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00417', 'ELDR00417', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Huma', '', 'Abbas', 'MD', 'Pediatric Psychiatry', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609039163', 0, 'Y', 0, '2014-01-13', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00418', 'ELDR00418', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'David', 'S', 'Leader', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609885474', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7618, -88.3621, NULL, NULL),
('364088232', 'ELDR00419', 'ELDR00419', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'David', 'S', 'Leader', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609885474', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00420', 'ELDR00420', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Judson', 'E', 'Jones', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648864', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648864', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1609894856', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00421', 'ELDR00421', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Judson', 'E', 'Jones', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6305853110', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6305853110', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1609894856', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00423', 'ELDR00423', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Judson', 'E', 'Jones', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1609894856', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00422', 'ELDR00422', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Judson', 'E', 'Jones', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512752', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512752', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1609894856', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00424', 'ELDR00424', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'James', 'W', 'LeFager', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1629188008', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7618, -88.3621, NULL, NULL),
('364088232', 'ELDR00425', 'ELDR00425', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'James', 'W', 'LeFager', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786694', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786694', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1629188008', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00426', 'ELDR00426', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'James', 'W', 'LeFager', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1629188008', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00427', 'ELDR00427', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Anisha', 'R', 'Shetty', 'MD', 'Pediatrics', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596744', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596744', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1629247465', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00428', 'ELDR00428', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Anisha', 'R', 'Shetty', 'MD', 'Pediatrics', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1629247465', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00429', 'ELDR00429', 'ILCHIGSTD', 'Dreyer Clinic', 'Dipti', 'M', 'Patel', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Aurora', 'Kane', 'IL', '60506', '6308792110', '6307624821', '2500 W Fabyan Pkwy', 'Aurora', 'Kane', 'IL', '60506', '6308792110', '6307624821', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639385651', 0, 'Y', 0, '2013-10-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00430', 'ELDR00430', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Dipti', 'M', 'Patel', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639385651', 0, 'Y', 0, '2013-10-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00431', 'ELDR00431', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Kristine', 'M', 'Bennett', 'PAC', 'Dermatology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065970', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065970', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2014-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649204041', 0, 'Y', 0, '2014-07-09', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00433', 'ELDR00433', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Kristine', 'M', 'Bennett', 'PAC', 'Dermatology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2014-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649204041', 0, 'Y', 0, '2014-07-09', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00432', 'ELDR00432', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Kristine', 'M', 'Bennett', 'PAC', 'Dermatology', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2014-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649204041', 0, 'Y', 0, '2014-07-09', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00434', 'ELDR00434', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Barry', 'L', 'Abrams', 'MD', 'Pediatrics', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1659305183', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00435', 'ELDR00435', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Barry', 'L', 'Abrams', 'MD', 'Pediatrics', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1659305183', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00436', 'ELDR00436', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Barry', 'L', 'Abrams', 'MD', 'Pediatrics', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1659305183', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00437', 'ELDR00437', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Barry', 'L', 'Abrams', 'MD', 'Pediatrics', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1659305183', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00438', 'ELDR00438', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Helen', 'M', 'Kellett', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1659373587', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00439', 'ELDR00439', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Helen', 'M', 'Kellett', 'MD', 'Diagnostic Radiology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6302648522', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1659373587', 0, 'Y', 0, '2014-04-17', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00440', 'ELDR00440', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Helen', 'M', 'Kellett', 'MD', 'Diagnostic Radiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1659373587', 0, 'Y', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00441', 'ELDR00441', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Anita', 'M', 'Gandhi', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924080', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924080', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659380277', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00443', 'ELDR00443', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Anita', 'M', 'Gandhi', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659380277', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
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('364088232', 'ELDR00444', 'ELDR00444', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Reyna', 'M', 'Trevino', 'MD', 'Pediatrics', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596744', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596744', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1669551115', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00445', 'ELDR00445', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Reyna', 'M', 'Trevino', 'MD', 'Pediatrics', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1669551115', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
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('364088232', 'ELDR00448', 'ELDR00448', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Fatema', 'M', 'Photowala', 'MD', 'Pulmonary', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1669674610', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
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('364088232', 'ELDR00449', 'ELDR00449', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Joseph', 'J', 'Coda', 'PsyD', 'Mental Health', 'Psychology', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065099', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065099', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669759981', 0, 'Y', 0, '2013-04-22', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00450', 'ELDR00450', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Joseph', 'J', 'Coda', 'PsyD', 'Mental Health', 'Psychology', '', NULL, 'O', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669759981', 0, 'Y', 0, '2013-04-22', NULL, NULL, 41.7618, -88.3621, NULL, NULL),
('364088232', 'ELDR00451', 'ELDR00451', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Joseph', 'J', 'Coda', 'PsyD', 'Mental Health', 'Psychology', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669759981', 0, 'Y', 0, '2013-04-22', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00452', 'ELDR00452', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Sharon', 'D', 'Chavez', 'PAC', 'Internal Medicine', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624779', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624779', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1679506372', 0, 'Y', 0, '2013-04-17', NULL, NULL, 41.8633, -88.269, NULL, NULL),
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('364088232', 'ELDR00454', 'ELDR00454', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Gregory', 'G', 'Neri', 'MD', 'Radiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1679607485', 0, 'Y', 0, '2014-04-07', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00455', 'ELDR00455', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Gregory', 'G', 'Neri', 'MD', 'Radiology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60505', '6308596700', '6302648522', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60505', '6308596700', '6302648522', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1679607485', 0, 'Y', 0, '2014-04-17', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00456', 'ELDR00456', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Gregory', 'G', 'Neri', 'MD', 'Radiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', '', '', '', 'HCFA|UB|', '1679607485', 0, 'Y', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00457', 'ELDR00457', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Deanna', 'J', 'Wyatt', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679703946', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, 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
('364088232', 'ELDR00458', 'ELDR00458', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Deanna', 'J', 'Wyatt', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065099', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065099', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679703946', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00459', 'ELDR00459', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Deanna', 'J', 'Wyatt', 'PT', 'Physical Therapy', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6304829200', '6307624774', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6304829200', '6307624774', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679703946', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00461', 'ELDR00461', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Deanna', 'J', 'Wyatt', 'PT', 'Physical Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679703946', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00460', 'ELDR00460', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Deanna', 'J', 'Wyatt', 'PT', 'Physical Therapy', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512740', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512740', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679703946', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00462', 'ELDR00462', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Marlene', '', 'Erdman', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308597275', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308597275', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1689609455', 0, 'Y', 0, '2013-04-22', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00463', 'ELDR00463', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Marlene', '', 'Erdman', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1689609455', 0, 'Y', 0, '2013-04-22', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00465', 'ELDR00465', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jennifer', 'R', 'Crane', 'MD', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1689699902', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00464', 'ELDR00464', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jennifer', 'R', 'Crane', 'MD', 'Family Practice', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1689699902', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00466', 'ELDR00466', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ann', 'C', 'Schulz', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1689813792', 0, 'Y', 0, '2013-04-22', NULL, NULL, 41.7618, -88.3621, NULL, NULL),
('364088232', 'ELDR00467', 'ELDR00467', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ann', 'C', 'Schulz', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786694', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786694', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1689813792', 0, 'Y', 0, '2013-04-22', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00468', 'ELDR00468', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ann', 'C', 'Schulz', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1689813792', 0, 'Y', 0, '2013-04-22', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00469', 'ELDR00469', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Paula', 'C', 'Gewarges', 'DO', 'Mental Health', 'Pediatric Psychiatry', '', NULL, 'O', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1699713347', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7618, -88.3621, NULL, NULL),
('364088232', 'ELDR00470', 'ELDR00470', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Paula', 'C', 'Gewarges', 'DO', 'Mental Health', 'Pediatric Psychiatry', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1699713347', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00471', 'ELDR00471', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ann', 'M', 'Iglesias', 'APN', 'Internal Medicine', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1700983228', 0, 'Y', 0, '2013-04-17', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00472', 'ELDR00472', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ann', 'M', 'Iglesias', 'APN', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1700983228', 0, 'Y', 0, '2013-04-17', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00473', 'ELDR00473', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Patricia', 'E', 'Rosenmann', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'O', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710032404', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7618, -88.3621, NULL, NULL),
('364088232', 'ELDR00474', 'ELDR00474', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Patricia', 'E', 'Rosenmann', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710032404', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00475', 'ELDR00475', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Nicolle', 'R', 'Unger', 'OT', 'Occupational Therapy', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1710083951', 0, 'Y', 0, '2013-06-04', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00476', 'ELDR00476', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Nicolle', 'R', 'Unger', 'OT', 'Occupational Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1710083951', 0, 'Y', 0, '2013-06-04', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00477', 'ELDR00477', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Amar', '', 'Bansal', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1710929716', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00478', 'ELDR00478', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Amar', '', 'Bansal', 'MD', 'Gastroenterology', '', '', NULL, 'O', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1710929716', 0, 'N', 0, '2013-04-04', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00479', 'ELDR00479', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Amar', '', 'Bansal', 'MD', 'Gastroenterology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1710929716', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00481', 'ELDR00481', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Roy', 'F', 'Houlahan', 'MD', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1720011752', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00480', 'ELDR00480', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Roy', 'F', 'Houlahan', 'MD', 'Family Practice', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1720011752', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00482', 'ELDR00482', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lawrence', 'E', 'Alberti', 'MD', 'Pulmonary', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720015431', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00483', 'ELDR00483', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lawrence', 'E', 'Alberti', 'MD', 'Pulmonary', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720015431', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00484', 'ELDR00484', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Thad', 'L', 'Cuasay', 'PAC', 'Occupational Medicine', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624730', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624730', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730112277', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00485', 'ELDR00485', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Thad', 'L', 'Cuasay', 'PAC', 'Occupational Medicine', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730112277', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00486', 'ELDR00486', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Thad', 'L', 'Cuasay', 'PAC', 'Occupational Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730112277', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00487', 'ELDR00487', 'ILCHIGSTD', 'Dreyer Clinic', 'Premesh', '', 'Malapati', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065941', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065941', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-10-18', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1730136763', 0, 'N', 0, '2013-11-06', NULL, NULL, 41.7625, -88.3623, NULL, NULL),
('364088232', 'ELDR00488', 'ELDR00488', 'ILCHIGSTD', 'Dreyer Clinic', 'Premesh', '', 'Malapati', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-10-18', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1730136763', 0, 'Y', 0, '2013-11-06', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00489', 'ELDR00489', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jill', 'H', 'Austin', 'DPM', 'Podiatry', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648423', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648423', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1730164047', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00490', 'ELDR00490', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jill', 'H', 'Austin', 'DPM', 'Podiatry', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924129', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924129', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1730164047', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00491', 'ELDR00491', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jill', 'H', 'Austin', 'DPM', 'Podiatry', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1730164047', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00492', 'ELDR00492', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Navinchandra', 'J', 'Dodhia', 'MD', 'Nephrology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1740213149', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00493', 'ELDR00493', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Navinchandra', 'J', 'Dodhia', 'MD', 'Nephrology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1740213149', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00494', 'ELDR00494', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Tosca', 'M', 'Kekish', 'MD', 'Ophthalmology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648809', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648809', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1740214915', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00495', 'ELDR00495', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Tosca', 'M', 'Kekish', 'MD', 'Ophthalmology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1740214915', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00496', 'ELDR00496', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Noel', 'C', 'Taylor', 'PTDPT', 'Physical Therapy', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740256353', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00497', 'ELDR00497', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Noel', 'C', 'Taylor', 'PTDPT', 'Physical Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740256353', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00498', 'ELDR00498', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Kristin', 'M', 'Keller', 'OT', 'Occupational Therapy', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1740385368', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00499', 'ELDR00499', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Kristin', 'M', 'Keller', 'OT', 'Occupational Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1740385368', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00500', 'ELDR00500', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Wailam', 'A', 'Kwok', 'MD', 'Cardiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648639', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1740397892', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00501', 'ELDR00501', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Wailam', 'A', 'Kwok', 'MD', 'Cardiology', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924005', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924005', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1740397892', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00502', 'ELDR00502', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Wailam', 'A', 'Kwok', 'MD', 'Cardiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1740397892', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00504', 'ELDR00504', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Carli', 'T', 'Spanik', 'MD', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1740446392', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00503', 'ELDR00503', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Carli', 'T', 'Spanik', 'MD', 'Family Practice', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1740446392', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00505', 'ELDR00505', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Mohammed', 'A', 'Raheem', 'MD', 'Hematology and Oncology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648858', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648858', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1750394805', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00506', 'ELDR00506', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Mohammed', 'A', 'Raheem', 'MD', 'Hematology and Oncology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1750394805', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00507', 'ELDR00507', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'J', 'Conrad', 'MD', 'Urology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648828', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1760557904', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00508', 'ELDR00508', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'J', 'Conrad', 'MD', 'Urology', '', '', NULL, 'O', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1760557904', 0, 'N', 0, '2013-04-04', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00509', 'ELDR00509', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Michael', 'J', 'Conrad', 'MD', 'Urology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1760557904', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00510', 'ELDR00510', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jerry', 'G', 'Morton', 'MD', 'Hospitalist', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308593248', NULL, '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308593248', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1760603930', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00511', 'ELDR00511', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Jerry', 'G', 'Morton', 'MD', 'Hospitalist', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1760603930', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00512', 'ELDR00512', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Alan', 'C', 'Jacobson', 'MD', 'Rheumatology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596811', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1770501900', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00513', 'ELDR00513', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Alan', 'C', 'Jacobson', 'MD', 'Rheumatology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1770501900', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00514', 'ELDR00514', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Fred', 'V', 'Kemp', 'MD', 'Dermatology', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065970', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6309065970', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1780603118', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00515', 'ELDR00515', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Fred', 'V', 'Kemp', 'MD', 'Dermatology', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6304829200', '6307624821', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6304829200', '6307624821', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1780603118', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00516', 'ELDR00516', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Fred', 'V', 'Kemp', 'MD', 'Dermatology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1780603118', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00517', 'ELDR00517', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Tina', 'L', 'Williams', 'AUD', 'Audiology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648484', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648484', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780789735', 0, 'Y', 0, '2013-02-21', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00518', 'ELDR00518', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Tina', 'L', 'Williams', 'AUD', 'Audiology', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924057', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924057', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780789735', 0, 'Y', 0, '2013-02-21', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00519', 'ELDR00519', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Tina', 'L', 'Williams', 'AUD', 'Audiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780789735', 0, 'Y', 0, '2013-02-21', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00520', 'ELDR00520', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lois', 'E', 'Norberg', 'APN', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648864', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648864', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1801993324', 0, 'Y', 0, '2013-04-17', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00521', 'ELDR00521', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lois', 'E', 'Norberg', 'APN', 'Obstetrics and Gynecology', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924080', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924080', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1801993324', 0, 'Y', 0, '2013-04-17', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00522', 'ELDR00522', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lois', 'E', 'Norberg', 'APN', 'Obstetrics and Gynecology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1801993324', 0, 'Y', 0, '2013-04-17', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00523', 'ELDR00523', 'ILCHIGSTD', 'Dreyer Clinic', 'Jessica', 'L', 'Novak', 'LCSW  CADC', 'Mental Health', 'Social Worker', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786694', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786694', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811178262', 0, 'Y', 0, '2013-07-09', NULL, NULL, 41.7524, -88.2148, NULL, NULL),
('364088232', 'ELDR00524', 'ELDR00524', 'ILCHIGSTD', 'Dreyer Clinic', 'Jessica', 'L', 'Novak', 'LCSW  CADC', 'Mental Health', 'Social Worker', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811178262', 0, 'Y', 0, '2013-07-09', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00525', 'ELDR00525', 'ILCHIGSTD', 'Dreyer Clinic', 'Myhra', 'L', 'Roper', 'PT DPT', 'Physical Therapy', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648444', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-05-10', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811250574', 0, 'Y', 0, '2013-05-28', NULL, NULL, 41.7828, -88.3276, NULL, NULL),
('364088232', 'ELDR00526', 'ELDR00526', 'ILCHIGSTD', 'Dreyer Clinic', 'Myhra', 'L', 'Roper', 'PT DPT', 'Physical Therapy', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-05-10', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811250574', 0, 'Y', 0, '2013-05-28', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00527', 'ELDR00527', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ronald', 'G', 'Bosh', 'MD', 'Internal Medicine', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624779', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624779', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1811928443', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00528', 'ELDR00528', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Ronald', 'G', 'Bosh', 'MD', 'Internal Medicine', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1811928443', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00529', 'ELDR00529', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Julie', 'B', 'Motycka', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648864', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648864', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821009259', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00530', 'ELDR00530', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Julie', 'B', 'Motycka', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924080', '2040 Ogden Ave', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924080', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821009259', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00531', 'ELDR00531', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Julie', 'B', 'Motycka', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821009259', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00532', 'ELDR00532', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Gary', 'G', 'Bowman', 'MD', 'Family Practice', '', '', NULL, 'O', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', '1870 W Galena Blvd', 'Aurora', 'Kane', 'IL', '60506', '6308596700', '6308596785', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821023748', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7642, -88.3626, NULL, NULL),
('364088232', 'ELDR00533', 'ELDR00533', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Gary', 'G', 'Bowman', 'MD', 'Family Practice', '', '', NULL, 'O', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', '2500 W Fabyan Pkwy', 'Batavia', 'Kane', 'IL', '60510', '6308792110', '6307624877', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821023748', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.8633, -88.269, NULL, NULL),
('364088232', 'ELDR00534', 'ELDR00534', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Gary', 'G', 'Bowman', 'MD', 'Family Practice', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786690', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821023748', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00535', 'ELDR00535', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Gary', 'G', 'Bowman', 'MD', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821023748', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00536', 'ELDR00536', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Elaine', 'C', 'Brodemus', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', '1877 W Downer Pl', 'Aurora', 'Kane', 'IL', '60506', '6309065120', '6309065093', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821108473', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7618, -88.3621, NULL, NULL),
('364088232', 'ELDR00537', 'ELDR00537', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Elaine', 'C', 'Brodemus', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786694', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786694', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821108473', 0, 'Y', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00538', 'ELDR00538', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Elaine', 'C', 'Brodemus', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821108473', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00539', 'ELDR00539', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'William', 'J', 'O Brien', 'MD', 'General Surgery', '', '', NULL, 'O', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648858', '1221 N Highland Ave', 'Aurora', 'Kane', 'IL', '60506', '6308598700', '6302648858', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1831101955', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7821, -88.3293, NULL, NULL),
('364088232', 'ELDR00540', 'ELDR00540', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'William', 'J', 'O Brien', 'MD', 'General Surgery', '', '', NULL, 'O', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', '2040 Ogden Ave Ste 605', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924110', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1831101955', 0, 'N', 0, '2013-04-04', NULL, NULL, 41.7282, -88.2677, NULL, NULL),
('364088232', 'ELDR00541', 'ELDR00541', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'William', 'J', 'O Brien', 'MD', 'General Surgery', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1831101955', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00543', 'ELDR00543', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Richard', 'P', 'Kelly', 'DO', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1831118264', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00542', 'ELDR00542', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Richard', 'P', 'Kelly', 'DO', 'Family Practice', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512933', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512933', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1831118264', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00544', 'ELDR00544', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lorene', 'S', 'Eckberg', 'MD', 'Pediatrics', '', '', NULL, 'O', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786605', '4100 Healthway Dr', 'Aurora', 'Dupage', 'IL', '60504', '6308513105', '6309786605', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1831122043', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.7522, -88.2131, NULL, NULL),
('364088232', 'ELDR00545', 'ELDR00545', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Lorene', 'S', 'Eckberg', 'MD', 'Pediatrics', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', NULL, 'HCFA|UB|', '1831122043', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00547', 'ELDR00547', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Scott', 'R', 'Goodwin', 'MD', 'Endocrinology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', '', 'HCFA|UB|', '1831310226', 0, 'Y', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00546', 'ELDR00546', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Scott', 'R', 'Goodwin', 'MD', 'Endocrinology', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, '', '', 'HCFA|UB|', '1831310226', 0, 'N', 0, '2013-05-06', NULL, NULL, 41.6724, -88.3381, NULL, NULL),
('364088232', 'ELDR00549', 'ELDR00549', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Heather', 'H', 'Weber', 'MD', 'Family Practice', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', NULL, '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1831319748', 0, 'Y', 0, '2012-12-19', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'ELDR00548', 'ELDR00548', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Heather', 'H', 'Weber', 'MD', 'Family Practice', '', '', NULL, 'O', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', '80 Templeton Dr', 'Oswego', 'Kendall', 'IL', '60543', '6305543456', '6305512970', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Mercy Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1831319748', 0, 'N', 0, '2012-12-19', NULL, NULL, 41.6724, -88.3381, NULL, NULL);
