Active NPI
Jennifer B Moran, M.D.
- Obstetrics & Gynecology Physician
- Bloomingdale, IL
National Provider Identifier
1710930276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 036-096586
- Practice address
- 471 W Army Trail Rd
Suite 103
Bloomingdale, IL 60108-2628 - Phone
- (630) 980-3366
- Fax
- (630) 980-3686
- NPI assigned
- May 18, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 036-096586 | IL | Primary |
Addresses
Primary practice location
471 W Army Trail Rd
Suite 103
Bloomingdale, IL 60108-2628
Mailing address
471 W Army Trail Rd
Suite 103
Bloomingdale, IL 60108-2628
Phone (630) 980-3366
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-096586 | IL | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trista Negele MD SC | Past | Accepting new patients | |
| Bonaventure Medical Foundation, LLC | Past | Accepting new patients | |
| Dr Paul K. Rosenberg, LTD | Obstetrics & Gynecology | Past | Accepting new patients |
| Alex B Lipowich MD SC | Obstetrics & Gynecology | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Obstetrics & Gynecology Physician
- Elk Grove Village, IL
- NPI 1669498648
-
- Family Medicine Physician
- Elk Grove Village, IL
- NPI 1588775647
-
- Obstetrics & Gynecology Physician
- Bloomingdale, IL
- NPI 1093865339
-
- Plastic Surgery Physician
- Elk Grove Village, IL
- NPI 1134206246
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318550400000",
"number": "1710930276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "471 W ARMY TRAIL RD",
"address_2": "SUITE 103",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "601082628",
"telephone_number": "630-980-3366",
"fax_number": "630-980-3686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "471 W ARMY TRAIL RD",
"address_2": "SUITE 103",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "601082628",
"telephone_number": "630-980-3366",
"fax_number": "630-980-3686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "JENNIFER",
"middle_name": "B",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-18",
"last_updated": "2011-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "036-096586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomingdale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.