Moore, Kellie Lynn

Moore, Kellie Lynn is an individual health care provider with primary practice located at 251 E Huron St , Chicago IL 60611. She recently has 3 registered licenses in different health care specialties including Dental Providers / General Practice, Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is her primary health care specialty. Moore, Kellie Lynn can be contacted via phone (312) 926-2000.

Contact Information

Primary practice address
251 E Huron St Chicago IL 60611
Phone: (312) 926-2000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 019031614 Illinois
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 019031614 Illinois

Profile Details

NPI number 1942705140
LBN Legal business name Moore, Kellie Lynn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2018
Last updated Jun 22nd, 2021 - about 5 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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