Active NPI
Eulonda Moulton, LMT
- Massage Therapist
- Forest Park, IL
National Provider Identifier
1851059059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 227022063
- Practice address
- 7435 Madison St
Forest Park, IL 60130-1542 - Phone
- (708) 613-5255
- Fax
- (708) 290-7434
- NPI assigned
- Dec 4, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227022063 | IL | Primary |
Addresses
Primary practice location
7435 Madison St
Forest Park, IL 60130-1542
Mailing address
7435 Madison St
Forest Park, IL 60130-1542
Phone (708) 613-5255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227022063 | IL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638576000000",
"number": "1851059059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7435 MADISON ST",
"city": "FOREST PARK",
"state": "IL",
"postal_code": "601301542",
"telephone_number": "708-613-5255",
"fax_number": "708-290-7434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7435 MADISON ST",
"city": "FOREST PARK",
"state": "IL",
"postal_code": "601301542",
"telephone_number": "708-613-5255",
"fax_number": "708-290-7434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOULTON",
"first_name": "EULONDA",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-04",
"last_updated": "2021-12-04",
"certification_date": "2021-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IL",
"license": "227022063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.