MEDICARE: REZNA HILL MOORE LMT

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
1	225700000X	Massage Therapist	227018250	IL

General Provider Information

NPI Number	:	1609649979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REZNA HILL MOORE LMT

Provider Business Mailing Address
First Line	:	2231 E 67TH ST APT 1003
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60649-1498
Country	:	US
Telephone Number	:	773-658-3435
Fax Number	:

Provider Business Practice Location Address
First Line	:	2231 E 67TH ST APT 1003
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60649-1498
Country	:	US
Telephone Number	:	773-658-3435
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2023
Last Update Date	:	10/30/2023

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Directions to “ REZNA HILL MOORE LMT” Practice Location

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