Individual
DR. MARKEITA R. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9730 S WESTERN AVE STE 500, EVERGREEN PARK, IL 60805-2780
(708) 425-7337
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036.127687
IL
208000000X
Pediatrics Physician
13157-320
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100306967
—
WI
Enumeration date
08/03/2008
Last updated
02/18/2025
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