Moore, Evelyn Marie
Moore, Evelyn Marie is an individual health care provider with primary practice located at 2032 N Prospect Ave , Champaign IL 61822-1240. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Moore, Evelyn Marie can be contacted via phone (217) 954-1085.Contact Information
Primary practice address
2032 N Prospect Ave
Champaign IL 61822-1240
Phone: (217) 954-1085
Fax: (217) 607-5457
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046.006881 | Illinois |
Profile Details
| NPI number | 1497826655 |
|---|---|
| LBN Legal business name | Moore, Evelyn Marie |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 10th, 2006 |
| Last updated | Dec 30th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497826655 | NPPES |
| Illinois | Other | 0001084006 | BLUE CROSS BLUE SHIELD |
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