Moore, Carol J

Moore, Carol J is an individual health care provider with primary practice located at 11308 Distinctive Dr , Orland Park IL 60467-9459. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as her primary health care specialty. Moore, Carol J can be contacted via phone (708) 479-6460.

Contact Information

Primary practice address
11308 Distinctive Dr Orland Park IL 60467-9459
Phone: (708) 479-6460
Fax: (708) 479-6462
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 016004283 Illinois

Profile Details

NPI number 1801856927
LBN Legal business name Moore, Carol J
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Jan 4th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801856927 NPPES
Illinois Other 016004283 ILLINOIS LICENSE NUMBER

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