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Organization
RHMOELLERENTERPRISES
Active
Organization
RHMOELLERENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND HENRY MOELLER MD (OWNER)
(630) 573-0360
Entity
Organization
Contact information
Practice address
120 OAKBROOK CTR, #204, OAK BROOK, IL 60523-4716
(630) 573-0360
Mailing address
120 OAKBROOK CTR, #204, OAK BROOK, IL 60523-4716
(630) 573-0360
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2201654
BLUE CROSS, BLUE SHIELD
IL
01
—
K19185
PIN#
IL
Enumeration date
10/04/2007
Last updated
11/02/2007
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