Individual provider Active NPI

Angelica Moran

  • Clinical Pathology Physician
  • Chicago, IL
National Provider Identifier
1164878195
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology PhysicianTaxonomy code 207ZC0006X
License
036158724 Issued in IL
Practice address
5841 S Maryland Ave # 3083
Chicago, IL 60637
Phone
(773) 702-1000
NPI assigned
May 9, 2016
Last updated
Aug 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology Physician 207ZC0006X 125.073611 IL
Clinical Pathology Physician 207ZC0006X 036158724 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave # 3083
Chicago, IL 60637

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150

Other practice location 1

5841 S Maryland Ave # 3083
Chicago, IL 60637
Phone (773) 834-2555

Other practice location 2

2650 Ridge Ave
Dep. of Pathology
Evanston, IL 60201
Phone (847) 570-2181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230703000699 IL Practitioner - Pathology 5193059764 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Northwestern University Feinberg Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

Practice addresses (Care Compare)

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (888) 824-0200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036158724ILMDClinical Pathology Physician
125.073611ILMDClinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Aug 1, 2024 Accepting new patients
The University of Chicago Medical Center CurrentSince Aug 1, 2024 Accepting new patients
Endeavor Health Medical Group CurrentSince Jun 20, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince Jun 20, 2023 Accepting new patients
University of Chicago CurrentSince Aug 1, 2024 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

180 Harvester Dr
Ste 110
Burr Ridge, IL 60527
Phone (773) 702-1061

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: amoran179736@uchospital.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1164878195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # 3083",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60637",
            "telephone_number": "773-702-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave # 3083",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60637",
            "country_code": "US",
            "telephone_number": "773-834-2555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2650 Ridge Ave",
            "address_2": "Dep. of Pathology",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "60201",
            "country_code": "US",
            "telephone_number": "847-570-2181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "ANGELICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-09",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "IL",
            "license": "125.073611",
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "IL",
            "license": "036158724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.