Individual
ELLEN MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1801 W TAYLOR ST, CHICAGO, IL 60612-4795
(312) 996-3631
Mailing address
150 HARVESTER DR STE 300, BURR RIDGE, IL 60527-5965
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209015461
IL
Other
Enumeration date
07/24/2006
Last updated
10/09/2024
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