Organization
JACOB R MOORE MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB MOORE MD (PRESIDENT/TRESURER/SECRETARY)
(815) 988-3623
Entity
Organization
Contact information
Practice address
303 N JACKSON ST, MORRISON, IL 61270-3042
(815) 772-4003
Mailing address
3037 N SEMINARY AVE, CHICAGO, IL 60657-4335
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/08/2023
Last updated
12/08/2023
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