Individual provider Active NPI

Christopher G Moag, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1548790389
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
211 E Ontario St Ste 200
Chicago, IL 60611-3284
Phone
(312) 694-7000
Fax
(312) 926-6274
NPI assigned
Jun 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

211 E Ontario St Ste 200
Chicago, IL 60611-3284

Mailing address

211 E Ontario St Ste 200
Chicago, IL 60611-3284
Phone (312) 694-7000

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
I20230126000524 IL Practitioner - Physician Assistant 3274896113 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
54575CAMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Aug 4, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 4, 2025 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

211 E Ontario St
Ste 200
Chicago, IL 60611
Phone (312) 694-7000

660 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6100

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1548790389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E ONTARIO ST STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113284",
            "telephone_number": "312-694-7000",
            "fax_number": "312-926-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E ONTARIO ST STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113284",
            "telephone_number": "312-694-7000",
            "fax_number": "312-926-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOAG",
        "first_name": "CHRISTOPHER",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.