Nycole Moore

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209031400 Issued in IL

Practice address

5401 S Wentworth Ave
Chicago, IL 60609-6300

Phone

(773) 288-6900

NPI assigned

Jul 28, 2025

Last updated

Jul 28, 2025By the provider in NPPES

Sex

Unspecified or another gender identity

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nmoore27833@direct.achn.net

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.

• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Des Plaines, IL
  • NPI 1982783692
  Medicare reassignment
• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1699701383
  NPD
• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1912944125
  NPD

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

{
    "created_epoch": "1753660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1760365753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 S WENTWORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606096300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 S WENTWORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606096300",
            "telephone_number": "773-288-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NYCOLE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-07-28",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209031400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Ann Moore, LCSW
• Monica Annette Moore, M.D
• Monica J Moore, MPT
• Nataka Moore, PSY.D.
• Nicholas M Moore, PHD
• Patrice Moore
• Paul Moore
• Paula Lynette Moore
• Raven Moore
• Shawntrell Moore, MA LCPC

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.