Jacob R Moore MD SC

Primary specialty

Emergency Care Clinic/CenterTaxonomy code 261QE0002X

Legal business name

JACOB R MOORE MD SC

Practice address

303 N Jackson St
Morrison, IL 61270-3042

Phone

(815) 772-4003

NPI assigned

Dec 8, 2023

Last updated

Dec 8, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacob Moore, MDNPI 1750762928

Title

President/Tresurer/Secretary

Phone

(815) 988-3623

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacob Robert Moore, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1750762928
  NPD Authorized official

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1144097254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3037 N SEMINARY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N JACKSON ST",
            "city": "MORRISON",
            "state": "IL",
            "postal_code": "612703042",
            "telephone_number": "815-772-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB R MOORE MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-08",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "PRESIDENT/TRESURER/SECRETARY",
        "authorized_official_telephone_number": "815-988-3623",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Patrick Hanlon, O.D.
• Highlight HC of Morrison, LLC
• HNP Chiropractic LLC
• Homestead of Morrison Operations LLC
• Kjersten Mae Ivarson, PT
• Asad Jamal, M.D.
• David C Jennings, OD
• John a Tomasino Jr DDS PC
• Jarica Jordan
• Cherish Lamarche

• Emergency Care Clinic/Center in Morrison, IL
• Providers in Morrison, IL by specialty
• Emergency Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.