Mora, Ezequiel R

Mora, Ezequiel R is an individual health care provider with primary practice located at 954 W State St , Sycamore IL 60178-1335. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Mora, Ezequiel R can be contacted via phone (815) 895-9144.

Contact Information

Primary practice address
954 W State St Sycamore IL 60178-1335
Phone: (815) 895-9144
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 041.408204 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209.025250 Illinois

Profile Details

NPI number 1912641879
LBN Legal business name Mora, Ezequiel R
Credentials APRN FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2022
Last updated May 27th, 2022 - about 3 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.

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