IndividualActive
Clifford Moudy, I.D.C.
NPI 1679541676 · Independent Duty Corpsman · Great Lakes, IL
Provider details
- NPI number
- 1679541676
- Entity type
- Individual
- Primary specialty
- Independent Duty CorpsmanOther Service Providers
- Credential
- I.D.C.
- Sex
- Male
Specialties & taxonomies
Other Service Providers
Practice location
3001a Sixth St
Naval Hospital Great Lakes
Great Lakes, IL 60088-5230
Phone: (847) 688-2616
Approximate (ZIP-level) locationGet directions
Mailing address
26800 104th St
Trevor, WI 53179-9619
Registry dates
- Enumerated
- 2006-03-08
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.