Moore, Derek Raymond

Moore, Derek Raymond is an sole proprietor health care provider with primary practice located at 800 Roosevelt Rd Ste 206 , Glen Ellyn IL 60137-5839. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Moore, Derek Raymond can be contacted via phone (630) 423-5935.

Contact Information

Primary practice address
800 Roosevelt Rd Ste 206 Glen Ellyn IL 60137-5839
Phone: (630) 423-5935
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 34385 Illinois
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 178017617 Illinois

Profile Details

NPI number 1851876031
LBN Legal business name Moore, Derek Raymond
Credentials CADC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 3rd, 2018
Last updated Jun 24th, 2022 - about 3 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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