NPIMap

Organization Active NPI

Dr Moana, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dekalb, IL
National Provider Identifier
1003523366
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
DR MOANA, LLC
Practice address
401 E Hillcrest Dr
Dekalb, IL 60115-2407
Phone
(773) 656-2738
NPI assigned
Nov 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Joel Marc Filmore, EDD, LCPCNPI 1578903696
Title
Owner/Ceo
Phone
(773) 656-2738

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

401 E Hillcrest Dr
Dekalb, IL 60115-2407

Mailing address

401 E Hillcrest Dr
Dekalb, IL 60115-2407
Phone (773) 656-2738

Other names 1

  • Filmore Foundation: Social-Emotional Wellness Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL CAQH Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1003523366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E HILLCREST DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601152407",
            "telephone_number": "773-656-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E HILLCREST DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601152407",
            "telephone_number": "773-656-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MOANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A",
        "authorized_official_last_name": "FILMORE",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "MARC",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "773-656-2738",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "EDD, LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CAQH",
            "affiliation": "N",
            "endpointDescription": "National Clearinghouse",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "401 E Hillcrest Dr",
            "city": "Dekalb",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601152407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Filmore Foundation: Social-Emotional Wellness Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dekalb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.