Individual
BRIAN MOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
676 N SAINT CLAIR ST STE 1900, CHICAGO, IL 60611-2986
(312) 695-8900
Mailing address
723 W MELROSE ST APT 2F, CHICAGO, IL 60657-3435
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085.002876
IL
Other
Enumeration date
04/04/2007
Last updated
10/10/2011
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