Juanita Mora, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

036118624 Issued in IL

Practice address

4952 W Irving Park Rd
Chicago Allergy Center Suite 100
Chicago, IL 60641-2640

Phone

(773) 614-7315

Fax

(773) 644-1370

NPI assigned

May 6, 2008

Last updated

Apr 30, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Allergy/Immunology

Education

University College of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grand Vein Specialists LLCGroup PAC ID 9739343203, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/4283/brand/1/csg/1/fhir/r4
• Direct secure messaging: juanita.mora.1@4283.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grand Vein Specialists LLC

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1255603247
  Medicare reassignment Care Compare group NPD
• Associated Allergists and Asthma Specialists, LTD

  • Allergy Physician
  • Orland Park, IL
  • NPI 1720117823
  NPD (past)
• Ear, Nose & Throat Specialists of Illinois LTD

  • Specialist
  • Park Ridge, IL
  • NPI 1750340949
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430352000000",
    "number": "1750557179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4952 W IRVING PARK RD",
            "address_2": "100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412640",
            "telephone_number": "773-614-7315",
            "fax_number": "773-644-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4952 W IRVING PARK RD",
            "address_2": "CHICAGO ALLERGY CENTER SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412640",
            "telephone_number": "773-614-7315",
            "fax_number": "773-644-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "JUANITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-06",
        "last_updated": "2015-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IL",
            "license": "036118624",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036118624",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "0368118624",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Moquin, MSW
• Guido Mora Calderon, MD
• Stephanie Mora Hernandez
• Andrea Mora
• Evette Mora
• Lesley Noa Mora, LCPC
• Maria Alejandra Mora, DDS, MS
• Virginia Sperling Mora, MPT
• Yuriana Mora
• Hanna Michelle Moradi, MD

• Allergy & Immunology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Allergy & Immunology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.