Individual provider Active NPI

Thomas Moran, MD

  • Emergency Medicine Physician
  • Winfield, IL
National Provider Identifier
1770672685
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Practice address
25 N. Winfield Road
Winfield, IL 60190
Phone
(630) 933-2640
NPI assigned
Oct 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X IL Primary

Addresses

Primary practice location

25 N. Winfield Road
Winfield, IL 60190

Mailing address

PO Box 5940
Carol Stream, IL 60197-5940
Phone (630) 734-0200

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20061218000049 IL Practitioner - Emergency Medicine 2163421348 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036089795ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2022 Accepting new patients
Central Dupage Emergency Physicians, PC Emergency Medicine CurrentSince Jan 1, 2007 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

21202 Owens Rd
Ste 101
Mokena, IL 60448
Phone (779) 334-0030

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770672685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5940",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601975940",
            "telephone_number": "630-734-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N. WINFIELD ROAD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "60190",
            "telephone_number": "630-933-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winfield, IL

Sources for this page

Verify at the official NPI Registry.