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Contact Information

MOE TAKEDA
5841 S MARYLAND AVE # MC3083
CHICAGO, IL60637-1443
 Phone: 773-834-7708
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hematology

207ZH0000X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for MOE TAKEDA · (Female)

NPI # 1982068789
Status Active
Credentials
Entity Individual
Enumeration date 04/07/2016
Last updated 04/27/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 036151372
Hospital affiliation(s) Not Available
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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