John A Moore
Pediatric Allergist
611 W Park St
Urbana
, Illinois 61801-2529
John A Moore
Pediatric Allergist
611 W Park St
Urbana
, Illinois 61801-2529
(217) 383-4752
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About
Features
Specialties
- Pediatric Allergist
Languages spoken
- English
Location
First Address
- John A Moore
- 611 W Park St Bwpc
- Urbana, IL
- Zip : 61801-2529
- Fax : (217) 383-4752
- Phone : (217) 383-6792
Second Address
- John A Moore
- 611 W Park St
- Urbana, IL
- Zip : 61801-2529
- Fax : (217) 383-4468
- Phone : (217) 383-3100
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0201X | Pediatric Allergist | 036042907 | IL |
National Provider Identifier
| NPI | 1740293562 |
|---|---|
| Provider Name | John A Moore |
| First Address | Urbana, IL 61801-2529 |
| Second Address | Urbana, IL 61801-2529 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/08/2006 |
| Last Update Date | 07/05/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| C43413 | (02) | |
| C43413 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.