Individual
MAUREEN E MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
2650 WARRENVILLE RD, STE 280, DOWNERS GROVE, IL 60515
(630) 324-7911
(630) 324-7942
Mailing address
2650 WARRENVILLE RD, STE 280, DOWNERS GROVE, IL 60515
(630) 324-7911
(630) 324-7942
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085000424
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970002846
MEDICAID
IN
Enumeration date
08/01/2006
Last updated
03/31/2017
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