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Individual

JOHN PAUL MOULDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MDIV, MA

Contact information

Practice address
126 E CHESTNUT ST, CHICAGO, IL 60611-2014
(312) 787-8425
Mailing address
126 E CHESTNUT ST, CHICAGO, IL 60611-2014
(312) 787-8425

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
07/11/2018
Last updated
07/11/2018
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