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Individual

ANDREW MOODY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1701 CURTIS RD, CHAMPAIGN, IL 61822-9678
(217) 365-6206
Mailing address
611 W PARK ST, URBANA, IL 61801-2501

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
041313734
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209005597
IL

Other

Enumeration date
12/21/2005
Last updated
10/09/2025
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