National Provider Identifier Database

KENNETH L MOORE, MD – NPI #1891899258
Addiction Medicine

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


Contact Information

KENNETH L MOORE, MD
12 TARTAN RIDGE RD
BURR RIDGE, IL60527-8904
Phone: 630-323-1316
Fax:
Website:
Specialty Taxonomy Code
* Addiction Medicine 2084A0401X

* Indicates primary specialty

NPI Profile & details for KENNETH L MOORE

NPI Number 1891899258
Credentials MD
Entity Individual
Enumeration date 09/07/2006
Last updated 01/20/2016 - About 10 years ago
Sole proprietor1 Yes
Identifiers
  • IL License #: 036-053328
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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