Leslie Moyar

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

209.015115 Issued in IL

Practice address

475 Brown Blvd Ste 103
Bourbonnais, IL 60914-2325

Phone

(815) 937-7962

NPI assigned

Nov 9, 2016

Last updated

Jan 14, 2022By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Emergency Medical Specialists, II, S.C.

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1689004863
  NPD (past)
• New Choice Intervention, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Harvey, IL
  • NPI 1093394215
  NPD (past)
• New Choice Intervention, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Harvey, IL
  • NPI 1275967226
  NPD (past)

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

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1841732773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 N LAKE SHORE DR",
            "address_2": "APT 7B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571894",
            "telephone_number": "708-403-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BROWN BLVD STE 103",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142325",
            "telephone_number": "815-937-7962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10830 S HALSTED ST",
            "address_purpose": "LOCATION",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606283126",
            "country_code": "US",
            "telephone_number": "773-785-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOYAR",
        "first_name": "LESLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-09",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209.015115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen Morgan O'Connor, MD
• Morris I Esformes & Arnold Gassel
• William Mosenthal, M.D.
• Keith A Moss, MD
• Mouse Medical Inc
• Mensa Kamaugogo Muata, RSA
• Brock B Mullenbach, D.O.
• Pamela S. Munson, M.A. L.C.P.C.
• MX Behavioral Health SC
• Natural Health Remedies, LLC (Home Helpers)

• Acute Care Nurse Practitioner in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Acute Care Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.