Individual
ELENA S. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
036132978
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP1-0026448
INSTITUTIONAL PERMIT
—
Enumeration date
06/06/2007
Last updated
02/16/2021
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