Healthcare Provider Details

I. General information

NPI: 1902112188
Provider Name (Legal Business Name): MOINA UDDIN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 N ELM ST STE 309
HINSDALE IL
60521-3625
US

IV. Provider business mailing address

908 N ELM ST STE 309
HINSDALE IL
60521-3625
US

V. Phone/Fax

Practice location:
  • Phone: 847-490-4222
  • Fax:
Mailing address:
  • Phone: 847-490-4222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number036.132118
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: