Healthcare Provider Details

I. General information

NPI: 1033762802
Provider Name (Legal Business Name): PIAN PIAN MOY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2019
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 W CENTRAL RD STE 8200
ARLINGTON HEIGHTS IL
60005-2380
US

IV. Provider business mailing address

25070 NETWORK PL
CHICAGO IL
60673-1250
US

V. Phone/Fax

Practice location:
  • Phone: 847-259-4482
  • Fax: 847-259-6406
Mailing address:
  • Phone: 847-585-7000
  • Fax: 847-240-9093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209019635
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: