Individual provider Active NPI

Trischella Moore

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1609706753
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209035678 Issued in IL
Practice address
1236 E 53Rd St
Chicago, IL 60615-4008
Phone
(773) 231-0957
NPI assigned
May 20, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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 209035678 IL Primary

Addresses

Primary practice location

1236 E 53Rd St
Chicago, IL 60615-4008

Mailing address

PO Box 288461
Chicago, IL 60628-8421

Other practice location 1

4055 Valley View Ln Ste 700
Dallas, TX 75244-5045
Phone (855) 984-5121

Other practice location 2

PO Box 288461
Chicago, IL 60628-8421
Phone (773) 499-2279

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

40 75TH St
Willowbrook, IL 60527-2325

8777 Velocity Dr
Machesney Park, IL 61115-8002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209035678ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TDM Medical Staffing Agency PLLC Current Accepting new patients

Organizations & group practices 1

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": "1779235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1609706753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 288461",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606288421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 E 53RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154008",
            "telephone_number": "773-231-0957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4055 Valley View Ln Ste 700",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752445045",
            "country_code": "US",
            "telephone_number": "855-984-5121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "PO Box 288461",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606288421",
            "country_code": "US",
            "telephone_number": "773-499-2279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TRISCHELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-20",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209035678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.