Individual
DR. CAROL J MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
11308 DISTINCTIVE DR, ORLAND PARK, IL 60467-9459
(708) 479-6460
(708) 479-6462
Mailing address
11308 DISTINCTIVE DR, ORLAND PARK, IL 60467-9459
(708) 479-6460
(708) 479-6462
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004283
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016004283
ILLINOIS LICENSE NUMBER
IL
Enumeration date
03/24/2006
Last updated
01/04/2013
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