Active NPI
Maureen E Moran, PHYSICIAN ASSISTANT
- Physician Assistant
- Downers Grove, IL
National Provider Identifier
1861409393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085000424
- Practice address
- 2650 Warrenville Rd
Ste 280
Downers Grove, IL 60515 - Phone
- (630) 324-7911
- Fax
- (630) 324-7942
- NPI assigned
- Aug 1, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085000424 | IL | Primary |
Addresses
Primary practice location
2650 Warrenville Rd
Ste 280
Downers Grove, IL 60515
Mailing address
2650 Warrenville Rd
Ste 280
Downers Grove, IL 60515
Phone (630) 324-7911
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 970002846 | Other | IN | MEDICAID |
Other names 1
- Maureen E Hickey
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)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiac Surgery Associates SC | Past | Accepting new patients | |
| Wellsmith PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Downers Grove, IL
- NPI 1043269160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490918400000",
"number": "1861409393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2650 WARRENVILLE RD",
"address_2": "STE 280",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "60515",
"telephone_number": "630-324-7911",
"fax_number": "630-324-7942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 WARRENVILLE RD",
"address_2": "STE 280",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "60515",
"telephone_number": "630-324-7911",
"fax_number": "630-324-7942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "MAUREEN",
"middle_name": "E",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2017-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085000424",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "970002846",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MAUREEN",
"last_name": "HICKEY",
"middle_name": "E",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Downers Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.