Susan M. Moylan, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

28107622A Issued in IN

Practice address

2300 N Childrens PLZ
Box 24
Chicago, IL 60614-3363

Phone

(773) 880-4428

Fax

(773) 880-3339

NPI assigned

Jul 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Lurie Children'S Medical Group, LLC

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1992758544
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1275553950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 CHILDRENS PLZ",
            "address_2": "BOX 24",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143394",
            "telephone_number": "773-880-4428",
            "fax_number": "773-880-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N CHILDRENS PLZ",
            "address_2": "BOX 24",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143363",
            "telephone_number": "773-880-4428",
            "fax_number": "773-880-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYLAN",
        "first_name": "SUSAN",
        "middle_name": "M.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "28107622A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE NURSE",
            "identifier": "209.006870",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bret Moyer, RD
• Dale M Moyer, PH.D.
• Eric Paul Moyer
• Kari Violet Moyer, LCPC
• Kathleen T. Moyer, LCPC
• George Thomas Moynihan, M.D.
• Matthew Thomas Moynihan, DO
• Sikhumbuzo (Kim) Moyo, LCSW
• Mohammad Mozaffar
• Allison Mozdzen, LCSW

• Pediatric Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatric Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.