Individual
MS. DEMERIAL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6821 S HALSTED ST, CHICAGO, IL 60621-1833
(773) 651-3629
(773) 651-9268
Mailing address
6821 S HALSTED ST, CHICAGO, IL 60621-1833
(773) 651-3629
(773) 651-9268
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041324190
IL
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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