Tanisha Moore
Tanisha Moore is a Physician Assistant in Wilmette, Illinois. Practices as a sole proprietor. Licensed in Illinois.
- Licensed in
- IL
- In the registry since
- 2023
Practice location Address checks out
311A Ridge Rd Apt 113Wilmette, IL 60091-3256
Phone: (267) 505-6106
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Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 085-009934 (IL) |
|---|
Record details
| NPI number | 1558069542 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | February 20, 2023 |
| Last updated in NPPES | July 23, 2024 |
| Certification date | July 23, 2024 |
| Mailing address | 311a Ridge Rd Apt 113, Wilmette, IL 60091-3256 |
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