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PRINTED: 04/14/2011 FORM APPROVED DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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The printed form 04142011 - idph is a report used for reporting certain information to the IDPH.
Healthcare facilities and providers are required to file the printed form 04142011 - idph with the IDPH.
The printed form 04142011 - idph must be filled out completely and accurately following the instructions provided by the IDPH.
The purpose of printed form 04142011 - idph is to collect important data for public health monitoring and reporting purposes.
The printed form 04142011 - idph requires reporting of specific health-related data such as disease outbreaks, vaccination rates, and healthcare provider information.
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