Individual
KELLIE LYNN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
251 E HURON ST, CHICAGO, IL 60611
(312) 926-2000
Mailing address
251 E HURON ST, CHICAGO, IL 60611-3055
(312) 926-2000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019031614
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019031614
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2018
Last updated
06/22/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us