Moulton, Theresa M

Moulton, Theresa M is an sole proprietor health care provider with primary practice located at 1400 Sunset Ave Suite 5, Waukegan IL 60087-4806. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Moulton, Theresa M can be contacted via phone (224) 730-9331.

Contact Information

Primary practice address
1400 Sunset Ave Suite 5 Waukegan IL 60087-4806
Phone: (224) 730-9331
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 227-013352 Illinois

Profile Details

NPI number 1790199164
LBN Legal business name Moulton, Theresa M
Credentials LMT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 13th, 2014
Last updated Jun 13th, 2014 - about 10 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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