Individual
CHRISTOPHER C MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1235 CEDAR CT, CARBONDALE, IL 62901-5335
(618) 457-0431
(618) 457-5199
Mailing address
PO BOX 997, CARBONDALE, IL 62903-0997
(618) 457-0431
(618) 457-5199
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016003389
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016003389
—
IL
01
—
03922239
BLUE CROSS BLUE SHIELD
IL
01
—
CI5845 / 1013941392
RAILROAD MEDICARE
IL
Enumeration date
07/10/2006
Last updated
03/16/2022
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