Provider Demographics
NPI:1780670216
Name:MO, JOSEPHINE H (MD)
Entity Type:Individual
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First Name:JOSEPHINE
Middle Name:H
Last Name:MO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1550 N NORTHWEST HWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1411
Mailing Address - Country:US
Mailing Address - Phone:847-298-7024
Mailing Address - Fax:847-298-7155
Practice Address - Street 1:1009 IL ROUTE 22
Practice Address - Street 2:SUITE 2
Practice Address - City:FOX RIVER GROVE
Practice Address - State:IL
Practice Address - Zip Code:60021-1998
Practice Address - Country:US
Practice Address - Phone:847-842-9366
Practice Address - Fax:847-842-9467
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2012-12-30
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Provider Licenses
StateLicense IDTaxonomies
IL036106515207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036106515Medicaid
ILH75021Medicare UPIN
IL036106515Medicaid