Provider Demographics
NPI:1811185770
Name:RHMOELLERENTERPRISES
Entity Type:Organization
Organization Name:RHMOELLERENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:MOELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-573-0360
Mailing Address - Street 1:120 OAKBROOK CTR
Mailing Address - Street 2:#204
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-4716
Mailing Address - Country:US
Mailing Address - Phone:630-573-0360
Mailing Address - Fax:
Practice Address - Street 1:120 OAKBROOK CTR
Practice Address - Street 2:#204
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4716
Practice Address - Country:US
Practice Address - Phone:630-573-0360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK19185OtherPIN#
IL2201654OtherBLUE CROSS, BLUE SHIELD
IL212000Medicare PIN