Healthcare Provider Details

I. General information

NPI: 1871941427
Provider Name (Legal Business Name): DAVID MOY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2016
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W KIRCHHOFF RD
ARLINGTON HEIGHTS IL
60005-2361
US

IV. Provider business mailing address

901 W KIRCHHOFF RD
ARLINGTON HEIGHTS IL
60005-2361
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-0190
  • Fax: 847-618-0268
Mailing address:
  • Phone: 847-618-0190
  • Fax: 847-618-0268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number125068572
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: