Individual provider Active NPI

Talisha Moman

  • Licensed Practical Nurse
  • Chicago, IL
National Provider Identifier
1346786811
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
043.102708 Issued in IL
Practice address
7600 S. Pulaski Rd.
Suite 1106
Chicago, IL 60652
Phone
(773) 838-5748
NPI assigned
Jan 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 043.102708 IL Primary

Addresses

Primary practice location

7600 S. Pulaski Rd.
Suite 1106
Chicago, IL 60652

Mailing address

7600 S. Pulaski Rd.
Suite 1106
Chicago, IL 60652
Phone (773) 838-5748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
043.102708ILMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1346786811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 S. PULASKI RD.",
            "address_2": "SUITE 1106",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60652",
            "telephone_number": "773-838-5748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 S. PULASKI RD.",
            "address_2": "SUITE 1106",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60652",
            "telephone_number": "773-838-5748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMAN",
        "first_name": "TALISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-09",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043.102708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; 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.