Individual
TANEISHA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2829 W 87TH ST, EVERGREEN PARK, IL 60805-1135
(773) 370-3726
(773) 352-9492
Mailing address
22829 OAKLAND DR, STEGER, IL 60475-5933
(773) 370-3726
(773) 352-9492
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/22/2022
Last updated
06/23/2022
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