Active NPI
Elissa L. Moore, OTR/L
- Pediatric Occupational Therapist
- Glenview, IL
National Provider Identifier
1124273446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 056.009983
- Practice address
- 2591 Compass Rd
Suite 100
Glenview, IL 60026-8043 - Phone
- (847) 729-6220
- NPI assigned
- Dec 1, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 056.009983 | IL | Primary |
Addresses
Primary practice location
2591 Compass Rd
Suite 100
Glenview, IL 60026-8043
Mailing address
6338 N Clark St
Apt. 2F
Chicago, IL 60660-1260
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.009983 | IL | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360108800000",
"number": "1124273446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6338 N CLARK ST",
"address_2": "APT. 2F",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606601260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2591 COMPASS RD",
"address_2": "SUITE 100",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600268043",
"telephone_number": "847-729-6220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "ELISSA",
"middle_name": "L.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-01",
"last_updated": "2013-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "IL",
"license": "056.009983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenview, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.