Individual provider Active NPI

Laura Moran, PT, DPT

  • Physical Therapist
  • Lake Bluff, IL
National Provider Identifier
1790457448
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070040022 Issued in IL
Practice address
233 Waukegan Rd
Lake Bluff, IL 60044-1666
Phone
(847) 735-8104
NPI assigned
Oct 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 047734 NY
Physical Therapist 225100000X 0020300 CO
Physical Therapist 225100000X 070040022 IL Primary

Addresses

Primary practice location

233 Waukegan Rd
Lake Bluff, IL 60044-1666

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211018001443 NY Practitioner - Physical Therapist in Private Practice 9537567888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Drexel University College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spear Physical and Occupational Therapy, LLCGroup PAC ID 6901832112, 582 clinicians

Practice addresses (Care Compare)

57 W 57TH St
FL 15
New York, NY 10019-2832
Phone (646) 790-7464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047734NYMDPharmacist
0020300COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ventura Orthopedics Medical Group, Inc. Current Accepting new patients
Spear Physical and Occupational Therapy, LLC Physical Therapist CurrentSince Oct 8, 2021 Accepting new patients
Select Physical Therapy Holdings Inc Physical Therapist Past Accepting new patients

Locations

1203 Flynn Rd
Unit 160
Camarillo, CA 93012
Phone (805) 306-9700

2221 Wankel Way
Oxnard, CA 93030
Phone (805) 988-9366

3525 Loma Vista Rd
Ventura, CA 93003
Phone (805) 641-6415

3525 Loma Vista Rd
Ste C
Ventura, CA 93003
Phone (805) 652-6955

57 W 57th St
Fl 15
New York, NY 10019
Phone (212) 289-0700

120 E 56th St
Rm 1010
New York, NY 10022
Phone (646) 790-7466

31 E 32nd St
Fl 4
New York, NY 10016
Phone (646) 973-5427

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1790457448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 WAUKEGAN RD",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600441666",
            "telephone_number": "847-735-8104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "LAURA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047734",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0020300",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070040022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Bluff, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.