Individual
DOMINIQUE MOSELEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3008 E CHELTENHAM PL APT 706, CHICAGO, IL 60649-4854
(773) 727-2052
Mailing address
3008 E CHELTENHAM PL APT 706, CHICAGO, IL 60649-4854
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041440738
IL
163WI0600X
Infection Control Registered Nurse
041440738
IL
171M00000X
Case Manager/Care Coordinator
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041440738
REGISTERED NURSE HOME SERVICES
IL
05
—
041440738
—
IL
Enumeration date
06/29/2023
Last updated
06/29/2023
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