Individual provider Active NPI

Annie Moy

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1457752743
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209011482 Issued in IL
Practice address
3637 N Southport Ave
Chicago, IL 60613-3709
Phone
(866) 389-2727
NPI assigned
Sep 5, 2014
Last updated
Aug 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209011482 IL Primary

Addresses

Primary practice location

3637 N Southport Ave
Chicago, IL 60613-3709

Mailing address

3637 N Southport Ave
Chicago, IL 60613-3709
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20141106001307 IL Practitioner - Nurse Practitioner 3577785583 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Loyola University of Chicago, Stritch School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Illinois PLLCGroup PAC ID 8729171566, 106 clinicians
Minuteclinic Primary Care Illinois PLLCGroup PAC ID 7416471842, 102 clinicians

Practice addresses (Care Compare)

1200 N Larrabee St
Chicago, IL 60610-1746
Phone (866) 389-2727

2045 Plum Grove Rd
Rolling Meadows, IL 60008-1992
Phone (866) 389-2727

3637 N Southport Ave
Chicago, IL 60613-3709
Phone (866) 389-2727

741 W
31St
Chicago, IL 60616-3045
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209011482ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Illinois PLLC Family CurrentSince Sep 15, 2014 Accepting new patients
Minuteclinic Primary Care Illinois PLLC Family CurrentSince Apr 15, 2025 Accepting new patients

Locations

1130 S Veterans Pkwy
Bloomington, IL 61704
Phone (309) 661-1839

1165 N Clark St
Chicago, IL 60610
Phone (312) 280-8140

1200 N Larrabee St
Chicago, IL 60610
Phone (312) 470-8945

137 S State St
Chicago, IL 60603
Phone (312) 609-0521

2656 N Elston Ave
Chicago, IL 60647
Phone (773) 252-1994

3637 N Southport Ave
Chicago, IL 60613
Phone (773) 347-5282

4051 N Lincoln Ave
Chicago, IL 60618
Phone (773) 871-2611

741 W 31st St
Chicago, IL 60616
Phone (312) 567-9044

3333 Central St
Evanston, IL 60201
Phone (847) 563-9016

11200 Lincoln Hwy
Mokena, IL 60448
Phone 8154642171 ext. 8221

936 Willow Rd
Northbrook, IL 60062
Phone (847) 209-3814

2045 Plum Grove Rd
Rolling Meadows, IL 60008
Phone (847) 303-2450

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1457752743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3637 N SOUTHPORT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133709",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 N SOUTHPORT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133709",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOY",
        "first_name": "ANNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209011482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.