Individual provider Active NPI

Jennifer E Moravec, CNS

  • Clinical Nurse Specialist
  • Downers Grove, IL
National Provider Identifier
1144501479
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
209.008195 Issued in IL
Practice address
3815 Highland Ave
Downers Grove, IL 60515-1500
Phone
(630) 971-0664
NPI assigned
Aug 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.306949 IL
Clinical Nurse Specialist 364S00000X 209.008195 IL Primary

Addresses

Primary practice location

3815 Highland Ave
Downers Grove, IL 60515-1500

Mailing address

225 7TH St
Downers Grove, IL 60515-5350
Phone (630) 971-0664

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
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
041.306949ILMDRegistered Nurse
209.008195ILMDClinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1144501479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 7TH ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155350",
            "telephone_number": "630-971-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 HIGHLAND AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151500",
            "telephone_number": "630-971-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAVEC",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.306949",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "IL",
            "license": "209.008195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; 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.