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Evelyn Marie Moore O.d., P.c.
Durable Medical Equipment & Medical Supplies in Champaign, Illinois
NPI 1750670808

Evelyn Marie Moore O.d., P.c. is a Durable Medical Equipment & Medical Supplies based in Champaign, IL. Evelyn Marie Moore O.d., P.c. practices in Champaign, IL. The NPI Number for Evelyn Marie Moore O.d., P.c. is 1750670808 and holds a License No. 046006881 (Illinois).

The current practice location address for Evelyn Marie Moore O.d., P.c. is 501 S Mattis Ave, Champaign, IL and can be reached out via phone at 217-351-4106 and via fax at 217-351-4052.

Location: 501 S Mattis Ave, Champaign, IL, 61821-4274
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1750670808
Provider Name
Evelyn Marie Moore O.d., P.c.
Credential
Provider Entity Type
Organization
Address
501 S Mattis Ave, Champaign, IL, 61821-4274
Phone Number
217-351-4106
Fax Number
217-351-4052
Provider Enumeration Date
03/29/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1497826655 05 IL
institution
Provider Business Practice Location Address Details
Address
501 S Mattis Ave
City
Champaign
State
Illinois
Zip
61821-4274
Phone Number
217-351-4106
Fax Number
217-351-4052
person
Provider Business Mailing Address Details
Address
501 S Mattis Ave
City
Champaign
State
Illinois
Zip
61821-4274
Phone Number
217-351-4106
Fax Number
217-351-4052
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
046006881 (Illinois)
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
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