Egil T Moen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0380005678 Issued in IL

Practice address

18 12TH Ave
Orion, IL 61273

Phone

(309) 526-8001

Fax

(309) 526-8995

NPI assigned

Apr 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221609600000",
    "number": "1013971464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 508",
            "city": "ORION",
            "state": "IL",
            "postal_code": "612730508",
            "telephone_number": "309-526-8001",
            "fax_number": "309-526-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 12TH AVE",
            "city": "ORION",
            "state": "IL",
            "postal_code": "61273",
            "telephone_number": "309-526-8001",
            "fax_number": "309-526-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEN",
        "first_name": "EGIL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2008-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "0380005678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0003782017",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Orion, IL
• Providers in Orion, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; 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.