Active NPI
Albert Moore, OCCUPATIONAL THERAPY
- Occupational Therapist
- Downers Grove, IL
National Provider Identifier
1609046648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 1040 Robey Ave
Downers Grove, IL 60516-3445 - Phone
- (630) 969-9188
- NPI assigned
- Mar 5, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | IL | Primary |
Addresses
Primary practice location
1040 Robey Ave
Downers Grove, IL 60516-3445
Mailing address
9901 Linn Station Rd
Louisville, KY 40223-3808
Phone (800) 866-0860
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056-001290 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204675200000",
"number": "1609046648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9901 LINN STATION RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402233808",
"telephone_number": "800-866-0860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 ROBEY AVE",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605163445",
"telephone_number": "630-969-9188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "ALBERT",
"credential": "OCCUPATIONAL THERAPY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-05",
"last_updated": "2008-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Downers Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.