Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KENNETH LAWRENCE MOORE, M.D.
Active Sole ProprietorDR. KENNETH LAWRENCE MOORE, M.D. is a Addiction Psychiatry healthcare provider located in BURR RIDGE, Illinois. NPI 1891899258 is currently active in the NPPES registry. Verify at CMS.
Addiction Psychiatry · BURR RIDGE, IL
Registration Details
- NPI Number
- 1891899258
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 7, 2006 (19.957830972026 yrs)
- Last Updated
- Jan 20, 2016
- License
-
036-053328 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
12 TARTAN RIDGE RDBURR RIDGE, IL, 605278904Browse IL providers · Browse ZIP 60527
- Phone
- 6303231316
- Primary Specialty
-
Addiction Psychiatry
2084A0401X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.