Patricia M Moser OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008530 Issued in IL

Legal business name

PATRICIA M MOSER OD PC

Practice address

122-24 Broadview Village Square
Broadview, IL 60155

Phone

(708) 343-2099

Fax

(708) 343-2081

NPI assigned

Jun 25, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Patricia M. Moser, O.D.

Title

Owner

Phone

708034302099

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1285862490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 KRISTIN CT",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605593330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122-24 BROADVIEW VILLAGE SQUARE",
            "city": "BROADVIEW",
            "state": "IL",
            "postal_code": "60155",
            "telephone_number": "708-343-2099",
            "fax_number": "708-343-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA M MOSER OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "MOSER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708034302099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Broadview, IL
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.