Individual
LILLIAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4724 WEST 175TH PLACE, COUNTRY CLUB HILLS, IL 60478
(708) 253-8845
Mailing address
4724 WEST 175TH PLACE, COUNTRY CLUB HILLS, IL 60478
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
209011565
IL
Other
Enumeration date
06/09/2014
Last updated
06/09/2014
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