Kelly Ann Moore, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-13-12877

Practice address

5323 Fawn CT
Oak Forest, IL 60452-2200

Phone

(312) 771-2346

NPI assigned

Dec 29, 2013

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1388275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1790106342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17845 RIDGELAND AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604774383",
            "telephone_number": "312-771-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 FAWN CT",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604522200",
            "telephone_number": "312-771-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-29",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-13-12877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicki Miller
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• Lindsay Miroballi, M.A., L.P.C.
• Inder Mohini, PT
• Isaac Morcos, ISAAC MORCOS,M.D.
• Anne Elyse Morrill-Ploum, MA
• Sarah Mowrey, DPT
• Nancy Mrozek, APN
• Josephine Murray, RN BSN MS SLP

• Behavior Analyst in Oak Forest, IL
• Providers in Oak Forest, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; 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.