Lillian Moore

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

209011565 Issued in IL

Practice address

4724 West 175TH Place
Country Club Hills, IL 60478

Phone

(708) 253-8845

NPI assigned

Jun 9, 2014

Last updated

Jun 9, 2014By the provider in NPPES

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

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• Direct secure messaging: lillian.moore.1@14191.direct.athenahealth.com

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

• Okolocha Medical Corp.

  • Family Medicine Physician
  • Gary, IN
  • NPI 1902851330
  Medicare reassignment NPD

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1447663398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4724 WEST 175TH PLACE",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "60478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4724 WEST 175TH PLACE",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "60478",
            "telephone_number": "708-253-8845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LILLIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209011565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miracles Revealed Chiropractic Wellness Center
• Miracles Revealed Chiropractic Wellness Center
• Mission Driven Transportation Inc
• Arlene Mitchell, LSW
• Kenneth Mogbo
• MPB Transportation Services Incorporation
• Bikram Singh Mudhar, PHARMD
• Karen M Muhammad
• Dorothy Neal
• Tia Nix, MSW, LCSW

• Primary Care Nurse Practitioner in Country Club Hills, IL
• Providers in Country Club Hills, IL by specialty
• Primary Care Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.