Kenneth Lawrence Moore in Burr Ridge - Addiction Medicine
Kenneth Lawrence Moore - NPI 1891899258
Kenneth Lawrence Moore is a Addiction Medicine in Burr Ridge, Illinois. Kenneth Lawrence Moore practices all healthcare services and medical treatments related to Addiction Medicine. The NPI Number for Kenneth Lawrence Moore is 1891899258. The last update date is 2016-01-20.
Kenneth Lawrence Moore's current location address is 12 Tartan Ridge Road, Burr Ridge, Illinois. You can contact this provider via phone number 6303231316. The mailing address for Kenneth Lawrence Moore is 12 Tartan Ridge Road, Burr Ridge, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth Lawrence Moore |
|---|---|
| Address | 12 Tartan Ridge Road, Burr Ridge, Illinois |
| Phone Number | 6303231316 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1891899258 |
|---|---|
| Provider Enumeration Date | 2006-09-07 |
| Last Updated Date | 2016-01-20 |
Provider Mailing Address Detail
| Address | 12 Tartan Ridge Road |
|---|---|
| City | Burr Ridge |
| State | Illinois (IL) |
| Post Code | 605278904 |
| Phone Number | 6303231316 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Addiction Medicine |
|---|---|
| Taxonomy | 2084A0401X |
| Licence No | 036-053328 |
|
Definition: A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
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What is the unique 10-digit identifier code issued to Kenneth Lawrence Moore by the Centers for Medicare & Medicaid Services?
The Kenneth Lawrence Moore has been assigned the NPI (National Provider Identifier) 1891899258 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Kenneth Lawrence Moore is located?
The Kenneth Lawrence Moore is situated at the following address: 12 Tartan Ridge Road, Burr Ridge, IL, 605278904.
What is Kenneth Lawrence Moore's area of expertise and its corresponding taxonomy classification?
The Kenneth Lawrence Moore's field of specialization is Addiction Medicine, and it falls under the taxonomy code 2084A0401X, which categorizes healthcare providers based on their areas of practice.
When was the Kenneth Lawrence Moore's 1891899258 issued?
The Kenneth Lawrence Moore's 1891899258 was issued on 2006-09-07.
As of what date were the Kenneth Lawrence Moore's details last updated?
The information pertaining to the Kenneth Lawrence Moore, including its address, specialty, and other details, was most recently updated on 2016-01-20.
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