Individual provider Active NPI

Leslie Dy-Anne Moore-Hicks, CNM

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1871961813
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209013009 Issued in IL
Practice address
17 N State St FL 5
Chicago, IL 60602-3384
Phone
(312) 592-6800
Fax
(312) 592-6801
NPI assigned
Sep 8, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209013009 IL Primary
Advanced Practice Midwife 367A00000X 209013009 IL

Addresses

Primary practice location

17 N State St FL 5
Chicago, IL 60602-3384

Mailing address

8444 S Saint Lawrence Ave
Chicago, IL 60619-6023
Phone (773) 983-2536

Other names 1

  • Leslie Dy-Anne Moore Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180118001829 IL Practitioner - Certified Nurse Midwife (CNM) 6709145824 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Community Health Center CurrentSince Nov 1, 2017 Accepting new patients
Christian Community Health Center CurrentSince Nov 1, 2017 Accepting new patients
Christian Community Health Center Current Accepting new patients
Planned Parenthood of Illinois Past Accepting new patients
Planned Parenthood of Illinois Past Accepting new patients
Planned Parenthood of Illinois PastSince Oct 23, 2022 Accepting new patients
Planned Parenthood of Illinois Past Accepting new patients
Planned Parenthood of Illinois Past Accepting new patients
Planned Parenthood of Illinois Advanced Practice Midwife PastSince Oct 23, 2022 Accepting new patients
Planned Parenthood of Illinois Past Accepting new patients
Planned Parenthood of Illinois PastSince Oct 23, 2022 Accepting new patients
Planned Parenthood of Illinois Past Accepting new patients

Locations

364 Torrence Ave
Calumet City, IL 60409
Phone (708) 868-9457

9718 S Halsted St
Chicago, IL 60628
Phone (773) 233-4100

Organizations & group practices 12

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": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1871961813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8444 S SAINT LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606196023",
            "telephone_number": "773-983-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 N STATE ST FL 5",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023384",
            "telephone_number": "312-592-6800",
            "fax_number": "312-592-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE-HICKS",
        "first_name": "LESLIE",
        "middle_name": "DY-ANNE",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209013009",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209013009",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "MOORE",
            "middle_name": "DY-ANNE",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.