Individual
VERNON J MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
473 W ARMY TRAIL RD, SUITE 102, BLOOMINGDALE, IL 60108-2674
(630) 529-6969
(773) 561-3743
Mailing address
146 PARK AVE, RIVER FOREST, IL 60305-2040
(708) 771-2950
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
IL
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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