Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 019018695 | IL |
NPI | 1053453936 |
---|---|
Provider Name | Dr. Steven J Moravec |
First Address | Lockport, IL 60491-9008 |
Second Address | Plainfield, IL 60544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 19/01/2021 |