Keith A. Moss, M.d., Sc
NPI #1154520112 in Bourbonnais, Illinois
Provider Information
- NPI Number
- 1154520112
- Entity Type
- Organization
- Organization Name
- Keith A. Moss, M.d., Sc
- Primary Specialty
- Internal Medicine
- Enumeration Date
- Jul 11, 2007
- Last Updated
- May 28, 2008
Practice Location
- Address
- 300 RIVERSIDE DR
- Address 2
- SUITE 2400
- City
- Bourbonnais
- State
- Illinois
- ZIP Code
- 60914-4996
- Phone
- (815) 935-2784
Authorized Official
- Name
- KEITH A. MOSS, M.D.
- Title
- PRESIDENT
- Phone
- (815) 935-2784
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
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