Dennis M Moore MD SC

Primary specialty

Otology & Neurotology PhysicianTaxonomy code 207YX0901X

Legal business name

DENNIS M MOORE MD SC

Practice address

1875 Dempster
Suite 625
Park Ridge, IL 60068

Phone

(847) 518-1200

Fax

(847) 518-1209

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Janet A Moore, RN MSN

Title

Practice Manager

Phone

(847) 518-1200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053491639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER",
            "address_2": "SUITE 625",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "60068",
            "telephone_number": "847-518-1200",
            "fax_number": "847-518-1209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER",
            "address_2": "SUITE 625",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "60068",
            "telephone_number": "847-518-1200",
            "fax_number": "847-518-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS M MOORE MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "847-518-1200",
        "authorized_official_credential": "RN MSN"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jill Derose, LCSW

• Otology & Neurotology Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Otology & Neurotology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.