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Organization

MIDWEST ENVIRONMENTAL MEDICINE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERRENCE C MOISAN M.D. (PRESIDENT)
(708) 448-1400
Entity
Organization

Contact information

Practice address
12255 S 80TH AVE, PALOS HEIGHTS, IL 60463-1270
(708) 448-1400
Mailing address
10660 W 143RD ST, SUITE B, ORLAND PARK, IL 60462-1982
(708) 349-0055
(708) 460-8031

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
IL

Other

Enumeration date
01/17/2008
Last updated
01/17/2008
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