Active NPI
Elizabeth Moon
- Clinical Nurse Specialist
- Lindenhurst, IL
National Provider Identifier
1396148391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- 209009667
- Practice address
- 252 Thrush Cir
Lindenhurst, IL 60046-7948 - Phone
- (312) 420-9211
- NPI assigned
- Oct 3, 2014
- Last updated
- Oct 3, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 209009667 | IL | Primary |
Addresses
Primary practice location
252 Thrush Cir
Lindenhurst, IL 60046-7948
Mailing address
252 Thrush Cir
Lindenhurst, IL 60046-7948
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 17, 2022 through Nov 17, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209009667 | IL | MD | Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412294400000",
"number": "1396148391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "252 THRUSH CIR",
"city": "LINDENHURST",
"state": "IL",
"postal_code": "600467948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "252 THRUSH CIR",
"city": "LINDENHURST",
"state": "IL",
"postal_code": "600467948",
"telephone_number": "312-420-9211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-03",
"last_updated": "2014-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "IL",
"license": "209009667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lindenhurst, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.