Individual
DR. JAVIER A MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E NORTHWEST HWY, SUITE 620, PALATINE, IL 60074-6512
(847) 991-2222
(847) 991-2045
Mailing address
800 E NORTHWEST HWY, SUITE 620, PALATINE, IL 60074-6512
(847) 991-2222
(847) 991-2045
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036052532
IL
208600000X
Surgery Physician
036052532
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036052532
—
IL
Enumeration date
11/10/2009
Last updated
05/11/2011
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