Individual
KILEY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
126 E CHESTNUT ST FL 1, CHICAGO, IL 60611-2014
(312) 787-8425
Mailing address
4137 W NELSON ST, CHICAGO, IL 60641-5442
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/24/2022
Last updated
06/24/2022
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