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General NPI Number Information
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NPI Number | 1225265036
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Entity Type | Individual
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Provider Name | DEBRA PAUL MOORMAN RPH
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Gender | Female
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 06/18/2009
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Provider Practice Location Address
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Address Line | 217 SPARROW LN
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City | BOLINGBROOK
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State | IL
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Zip | 60490-4564
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Country | US
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Telephone | 630-809-5654
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Fax | 630-378-4331
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Provider Business Mailing Address
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Address Line | 217 SPARROW LN
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City | BOLINGBROOK
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State | IL
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Zip | 60490-4564
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Country | US
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Telephone | 630-809-5654
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Fax | 630-378-4331
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 051039084
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License Number State | IL
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