Terrence C Moisan, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

036050798 Issued in IL

Practice address

12255 S 80TH Ave
Palos Heights, IL 60463-1270

Phone

(708) 448-1400

NPI assigned

May 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Palos Imaging, LLC

  • Diagnostic Radiology Physician
  • Orland Park, IL
  • NPI 1417305350
  NPD Authorized official
• Palos Medical Group, LLC.

  • Obstetrics & Gynecology Physician
  • Orland Park, IL
  • NPI 1255660312
  NPD Authorized official
• South Campus Partners, Inc.

  • Radiation Oncology Clinic/Center
  • Orland Park, IL
  • NPI 1194220897
  NPD Authorized official
• Environmental & Respiratory Medicine

  • Pulmonary Disease Physician
  • Palos Heights, IL
  • NPI 1194831099
  NPD (past) Authorized official
• Palos Community Hospital

  • Psychiatric Hospital Unit
  • Palos Heights, IL
  • NPI 1184699118
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211068800000",
    "number": "1699722793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10660 W 143RD ST STE B",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604621989",
            "telephone_number": "708-349-0055",
            "fax_number": "708-460-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12255 S 80TH AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631270",
            "telephone_number": "708-448-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOISAN",
        "first_name": "TERRENCE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2008-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036050798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "036050798",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "290007170",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• ML Etchison and Associates, Inc.
• Ronald Mochizuki, M.D.
• James M Mohan, M.D.
• Latifa Mohsin
• Shakir Moiduddin, MD
• Candice Morales
• Phillip F Morreale, DPM
• Margaret Ann Moss I, LCSW
• Kimberly Ann Moyer, LCPC
• Nicole Kelly Mozden, M.D.

• Pulmonary Disease Physician in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Pulmonary Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.

Verify at the official NPI Registry.