Individual provider Active NPI

Deborah Moraga, LMT

  • Massage Therapist
  • Homewood, IL
National Provider Identifier
1669848164
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
227011279 Issued in IL
Practice address
2417 W 183Rd Street
Homewood, IL 60430
Phone
(708) 798-5556
Fax
(708) 798-5550
NPI assigned
Aug 19, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 227011279 IL Primary

Addresses

Primary practice location

2417 W 183Rd Street
Homewood, IL 60430

Mailing address

2417 W 183Rd Street
Homewood, IL 60430
Phone (708) 798-5556

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

LicenseStateTypeSpecialty
227011279ILMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sareena Health LLC PastSince Oct 25, 2017 Accepting new patients
Chiropractic Care LTD Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1669848164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2417 W 183RD STREET",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "60430",
            "telephone_number": "708-798-5556",
            "fax_number": "708-798-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2417 W 183RD STREET",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "60430",
            "telephone_number": "708-798-5556",
            "fax_number": "708-798-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAGA",
        "first_name": "DEBORAH",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227011279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.