Provider Demographics
NPI:1083700991
Name:MORAN, WILLIAM A (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:MORAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2101 S ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4185
Mailing Address - Country:US
Mailing Address - Phone:224-404-6500
Mailing Address - Fax:847-818-0061
Practice Address - Street 1:2101 S ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 108
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4185
Practice Address - Country:US
Practice Address - Phone:224-404-6500
Practice Address - Fax:847-818-0061
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2021-05-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036106016207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01633940OtherBCBS OF IL
IL036106016Medicaid
ILH77302Medicare UPIN