Individual
STEPHANIE MOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5700 S MARYLAND AVE, CHICAGO, IL 60637-1426
(312) 926-9123
Mailing address
811 E 38TH ST, CHICAGO, IL 60653-1921
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
041436857
IL
163WC0200X
Critical Care Medicine Registered Nurse
95120973
CA
363LA2100X
Acute Care Nurse Practitioner
209030415
IL
363LA2100X
Acute Care Nurse Practitioner
95031682
CA
Other
Enumeration date
09/16/2024
Last updated
09/16/2024
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