Search › Illinois › 376J00000X
Tina Moore
NPI 1679173967 · on the registry since 2020
Practice
- Address
- 347 Covington Dr Ste A
Waterloo, IL 62298 - Phone
- (618) 257-2200
- Fax
- (618) 257-2205
Registry record
- Primary taxonomy
- 376J00000X
376J00000X
- Also registered as
- 374U00000X
372600000X - Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2020-10-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois