| Kevin Patrick Moore, DC | |
|
2604 Dempster St, Ste 304, Park Ridge, IL 60068-8412 | |
| (847) 635-8080 | |
| (847) 390-8080 |
| Full Name | Kevin Patrick Moore |
|---|---|
| Gender | Male |
| Speciality | Chiropractic |
| Experience | 40 Years |
| Location | 2604 Dempster St, Park Ridge, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558432831 | NPI | - | NPPES |
| 016-36062 | Other | IL | BLUE CROSS BLUE SHIELD |
| 1649460270 | Other | IL | CORPORATE NPI |
| K14265 | Other | MEDICARE MEMBER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 038-005366 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Chiropractic And Acupuncture Center Inc | 2860442480 | 2 |
| Provider Name | Chiropractic And Acupuncture Center Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1649460270 PECOS PAC ID: 2860442480 Enrollment ID: O20050131000843 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Patrick Moore, DC 2604 Dempster St, Ste 304, Park Ridge, IL 60068-8412 Ph: (847) 635-8080 | Kevin Patrick Moore, DC 2604 Dempster St, Ste 304, Park Ridge, IL 60068-8412 Ph: (847) 635-8080 |
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