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Contact Information

MICHELLE G MOORE, EARLY INTERVENTION P
PO BOX 658
BLUE ISLAND, IL60406
 Phone: 708-698-0714
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Early Intervention Provider Agency

252Y00000X
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for MICHELLE G MOORE · (Female)

NPI # 1760649628
Status Active
Credentials EARLY INTERVENTION P
Entity Individual
Enumeration date 05/19/2008
Last updated 05/11/2026 - About a month ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 149027689
  • IL License # 150107720
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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