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NPI Code Detail

MEDICARE: JOSHUA MICHAEL MORAN

MEDICARE:   JOSHUA MICHAEL MORAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician036.169806IL
2207RR0500XRheumatology Physician036.169806IL

General Provider Information

NPI Number : 1578198354
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA MICHAEL MORAN
Provider Business Mailing Address
First Line : 818 S. WOLCOTT AVE. 6TH FLOOR
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3704
Country : US
Telephone Number : 312-355-6167
Fax Number : 312-413-9271
Provider Business Practice Location Address
First Line : 1801 W TAYLOR ST # 3D
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4795
Country : US
Telephone Number : 312-413-5569
Fax Number : 312-413-7835
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2020
Last Update Date : 06/26/2024

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Directions to “ JOSHUA MICHAEL MORAN ” Practice Location

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