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NPI Profile for Dr KENNETH L MOORE in BURR RIDGE, IL.
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
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction Medicine |
2084A0401X | 79 | Physician/Addiction Medicine |
| NPI Number | 1891899258 |
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| Status | Active | |
| Credentials | MD | |
| Entity | Individual | |
| Enumeration date | 09/07/2006 | |
| Last updated | 01/20/2016 - About 10 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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| Hospital affiliation(s) |
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KENNETH L MOORE
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KENNETH L MOORE, MD