Emilee Lane Moore, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.016136 Issued in IL

Practice address

3319 N Elston Ave Ste 200
Chicago, IL 60618-5811

Phone

(312) 312-7525

NPI assigned

Jul 31, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734134400000",
    "number": "1679302145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 N FRANCISCO AVE FL 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181410",
            "telephone_number": "308-440-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 N ELSTON AVE STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185811",
            "telephone_number": "312-312-7525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3709 N Kedzie Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606184503",
            "country_code": "US",
            "telephone_number": "773-377-5492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "EMILEE",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-12-14",
        "certification_date": "2024-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.016136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demerial Moore
• Denis G. Moore, AU.D.
• Destinee Sharae Moore, LCSW
• Duncan Fleming Moore, MD
• Eathel Antoinette Moore, CNA
• Emily A Moore, CT
• Emily Marie Moore, M.A.
• Erica Moore
• Grace Elizabeth Moore, DDS
• Hannah Moore

• Occupational Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2024; 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.