Individual
ADILLS MOOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1750 E LAKE SHORE DR, DECATUR, IL 62521-3803
(217) 464-1440
Mailing address
4111 FRANKLIN ST, MICHIGAN CITY, IN 46360-7803
(219) 879-5400
(219) 879-5900
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
02005491A
IN
2083X0100X
Occupational Medicine Physician
R-10649
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2014
Last updated
01/06/2022
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