| Provider / Organization | NPI | Date Certified |
|---|---|---|
| TIM DANIEL MOELLER | 1669119301 | 2022-05-15 |
Tim Daniel Moeller is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1669119301. Registration indicates Tim Daniel Moeller is a provider of services with a specialization in Dermatology (Allopathic & Osteopathic Physicians, Dermatology) (Specialist Network, ) (Dermatology, Allopathic & Osteopathic Physicians) Access to Adult/Geriatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| Entity Type | Individual |
| Provider Name | Tim Daniel Moeller PA- C |
| Practice Office Address | 40 S CLAY ST HINSDALE, IL US |
| Practice Office Telephone | 6302865050 |
| Mailing Address | 1860 PAYSPHERE CIR CHICAGO, IL 606740018 US |
| Business Telephone | 6304699200 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 1801 S Highland Ave | Lombard, IL 601484932 | 6302865050 |
| Direct Messaging Address [] | [email protected] | Direct |
| Code | Practice | License No State |
|---|---|---|
| 207N00000X | Dermatology Allopathic & Osteopathic Physicians Dermatology Specialist Network Dermatology Allopathic & Osteopathic Physicians | 085.008949
IL |
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | 085-008949
IL |