Individual
ADAM JOSEPH MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 HEALTH CENTER DR, MATTOON, IL 61938-4644
(217) 258-2440
(217) 258-2186
Mailing address
10468 E KINGWOOD DR, EFFINGHAM, IL 62401-4354
(217) 343-1411
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
1316435548
IL
Other
Enumeration date
04/24/2018
Last updated
09/14/2022
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