Julie A Moore
Dermatologist
501 W North Ave Ste 103
Melrose Park
, Illinois 60160-1603
Julie A Moore
Dermatologist
501 W North Ave Ste 103
Melrose Park
, Illinois 60160-1603
(708) 450-5086
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About
Features
Specialties
- Dermatologist
Languages spoken
- English
Location
First Address
- Julie A Moore
- 501 W North Ave Ste 103
- Melrose Park, IL
- Zip : 60160-1603
- Phone : (708) 450-5086
Second Address
- Julie A Moore
- 501 W North Ave Ste 103
- Melrose Park, IL
- Zip : 60160-1603
- Phone : (708) 450-5086
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | 036075509 | IL |
National Provider Identifier
| NPI | 1053373589 |
|---|---|
| Provider Name | Julie A Moore |
| First Address | Melrose Park, IL 60160-1603 |
| Second Address | Melrose Park, IL 60160-1603 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/04/2006 |
| Last Update Date | 17/02/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036075509 | (05) | IL |
| E42133 | (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.