Jenna Moore

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096-003230 Issued in IL

Practice address

1450 Busch Pkwy
Suite 115a
Buffalo Grove, IL 60089-4541

Phone

(224) 676-7920

NPI assigned

Jun 12, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1285996579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8930 WAUKEGAN RD",
            "address_2": "SUITE 200",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532126",
            "telephone_number": "847-324-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 BUSCH PKWY",
            "address_2": "SUITE 115A",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894541",
            "telephone_number": "224-676-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096-003230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Olivia Momont
• Jaime M Monaco, LPC
• Lou Mongillo, LCSW
• Harry Keith Monroe, MD
• Mayra L Monterroso
• Kristin Moorhouse
• Robert I Morgan, D.C.
• Gary A Morris, D.D.S.
• Danielle Rudnick Morrissey, D.C.
• Laura Motanky-Borrelli, LCSW

• Athletic Trainer in Buffalo Grove, IL
• Providers in Buffalo Grove, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.