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Dr. Kenneth Lawrence Moore, MD
Addiction Medicine (Psychiatry & Neurology) Physician in Burr Ridge, Illinois
NPI 1891899258

Kenneth Lawrence Moore is an Addiction Medicine (Psychiatry & Neurology) Physician based in Burr Ridge, IL and is specialized in Addiction Medicine. Kenneth Lawrence Moore practices in Burr Ridge, IL and has the professional credentials of MD. The NPI Number for Kenneth Lawrence Moore is 1891899258 and holds a License No. 036-053328 (Illinois).

The current practice location address for Kenneth Lawrence Moore is 12 Tartan Ridge Rd, Burr Ridge, IL and can be reached out via phone at 630-323-1316.

Location: 12 Tartan Ridge Rd, Burr Ridge, IL, 60527-8904
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1891899258
Provider Name
Kenneth Lawrence Moore
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
12 Tartan Ridge Rd, Burr Ridge, IL, 60527-8904
Phone Number
630-323-1316
Fax Number
Provider Enumeration Date
09/07/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
12 Tartan Ridge Rd
City
Burr Ridge
State
Illinois
Zip
60527-8904
Phone Number
630-323-1316
Fax Number
person
Provider Business Mailing Address Details
Address
12 Tartan Ridge Rd
City
Burr Ridge
State
Illinois
Zip
60527-8904
Phone Number
630-323-1316
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Addiction Medicine
Taxonomy
2084A0401X
License No.
036-053328 (Illinois)
Definition
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
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