Individual
GEORGE GAW MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5201 WILLOW SPRINGS RD, SUITE 380, LA GRANGE HIGHLANDS, IL 60525-6537
(708) 354-2550
(708) 354-4552
Mailing address
5201 S WILLOW SPRINGS RD, SUITE 380, LAGRANGE, IL 60525-6537
(708) 354-2550
(708) 354-4552
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036-057691
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036057691
—
IL
Enumeration date
08/15/2006
Last updated
05/09/2011
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