Individual
DR. VICTOR A MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, EMS 110, RM 3293, MAYWOOD, IL 60153-3328
(708) 327-2335
Mailing address
233 E WACKER DR, #1402, CHICAGO, IL 60601-5104
(917) 686-4141
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
036.123000
IL
208600000X
Surgery Physician
244059
NY
208C00000X
Colon & Rectal Surgery Physician
244059
NY
Other
Enumeration date
12/06/2007
Last updated
08/02/2009
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