Individual
SUSAN M. MOYLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2300 N CHILDRENS PLZ, BOX 24, CHICAGO, IL 60614-3363
(773) 880-4428
(773) 880-3339
Mailing address
2300 CHILDRENS PLZ, BOX 24, CHICAGO, IL 60614-3394
(773) 880-4428
(773) 880-3339
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
28107622A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209.006870
ADVANCED PRACTICE NURSE
IL
Enumeration date
07/19/2006
Last updated
03/17/2008
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