Individual
LIA E MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNM
Contact information
Practice address
680 N LAKE SHORE DR STE 815, CHICAGO, IL 60611-4449
(312) 926-8811
(312) 587-9802
Mailing address
680 N LAKE SHORE DR STE 815, CHICAGO, IL 60611-4449
(312) 926-8811
(312) 587-9802
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041-34-8021
IL
367A00000X
Advanced Practice Midwife
Primary
209008272
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041-34-8021
LICENSE
IL
Enumeration date
05/07/2010
Last updated
06/27/2023
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