Individual
DR. EGIL T MOEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
18 12TH AVE, ORION, IL 61273
(309) 526-8001
(309) 526-8995
Mailing address
PO BOX 508, ORION, IL 61273-0508
(309) 526-8001
(309) 526-8995
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0380005678
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003782017
BLUE CROSS
IL
Enumeration date
04/13/2006
Last updated
09/17/2008
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