# JAVIER MORENO MD CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043713324
- **Authorized official:** DR. JAVIER A MORENO MD (PRESIDENT)
- **Authorized official phone:** (847) 620-9116

## Contact information

- **Practice address:** 1819 N NORMANDY AVE, CHICAGO, IL 60707-3927
- **Practice address phone:** (847) 620-9116
- **Practice address fax:** (844) 718-2707
- **Mailing address:** 1819 N NORMANDY AVE, CHICAGO, IL 60707-3927
- **Mailing address phone:** (847) 620-9116
- **Mailing address fax:** (844) 718-2707

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 036-052532 | IL | Yes |

## Other

- **Enumeration date:** 03/13/2018
- **Last updated:** 03/13/2018