Individual
MAHNOOR MOIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
15300 WEST AVE STE 210, ORLAND PARK, IL 60462-4686
(708) 226-2870
(708) 226-2390
Mailing address
15300 WEST AVE STE 210, ORLAND PARK, IL 60462-4686
(708) 226-2870
(708) 226-2390
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110006027
VA
363A00000X
Physician Assistant
Primary
085010543
IL
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639686009
—
VA
Enumeration date
01/05/2018
Last updated
10/15/2024
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