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General NPI Number Information
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NPI Number | 1588799522
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Entity Type | Organization
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Legal Business Name | MOORE ASSOCIATES IN WOMENS HEALTH
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 05/24/2019
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Provider Practice Location Address
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Address Line | 41 E 8TH ST
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City | CHICAGO
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State | IL
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Zip | 60605-2168
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Country | US
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Telephone | 312-212-9000
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Fax | 312-212-9003
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Provider Business Mailing Address
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Address Line | 4852 S CORNELL AVE
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City | CHICAGO
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State | IL
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Zip | 60615-3066
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Country | US
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Telephone | 312-212-9000
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Fax | 312-212-9003
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Authorized Official
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Title or Position | CMO
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Name | DR. MONICA A MOORE
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Credential | MD
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Telephone | 312-212-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 036096183
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License Number State | IL
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