Most Relevant Information
Provider Data
| NPI Number: | 1003264177 |
| Provider Name: | KRISTEN MARIE MOSER M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | 125.068571 |
Most Important Dates
| Enumeration Date: | 05/31/2016 |
| Last Updated: | 12/26/2019 |
Provider Practice Location
5359 W FULLERTON AVE
CHICAGO
IL
606391450
Practice Location Phone/Fax
| Phone: | 7738362785 |
| Fax: | 7738367381 |
Provider Mailing Location
5359 W FULLERTON AVE
CHICAGO
IL
606391450
Provider Mailing Phone/Fax
| Phone: | 7738362785 |
| Fax: | 7738367381 |