Spencer Mossack, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

1265061980 Issued in IL

Practice address

1800 Hollister Dr Ste 107
Libertyville, IL 60048-5265

Phone

(847) 295-0010

NPI assigned

Apr 4, 2020

Last updated

Jun 30, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Urology

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: spencer.mossack@stonybrookmedicine.edu

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

{
    "created_epoch": "1585958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1265061980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 SEVEN PONDS TOWD RD",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HOLLISTER DR STE 107",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485265",
            "telephone_number": "847-295-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSSACK",
        "first_name": "SPENCER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-04",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "1265061980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adriana Morrill
• Eileen T Morrison, MD
• Frances C Morrison, PSY.D.
• Chriszella Morson
• Stefanie Taylor Moss, L.C.P.C.
• Dimitrios T. Mougolias, M.D.
• Valeria Mourzaeva, CRNA
• Dean Mouscher, L.AC.
• Moving Toward Health LTD
• Megan Leigh Moyer, MA

• Urology Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Urology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.