Individual provider Active NPI

Monica Annette Moore, M.D

  • Gynecology Physician
  • Chicago, IL
National Provider Identifier
1912914490
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
036-096183 Issued in IL
Practice address
41 E 8TH St
Chicago, IL 60605-2168
Phone
(312) 212-9000
Fax
(312) 212-9003
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 036-096183 IL Primary

Addresses

Primary practice location

41 E 8TH St
Chicago, IL 60605-2168

Mailing address

9119 S Exchange Ave
Chicago, IL 60617-4225
Phone (773) 768-5000

Other identifiers 1

IdentifierTypeStateIssuer
036-096183MedicaidIL

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070606000422 IL Practitioner - Obstetrics/Gynecology 1456459908 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-096183ILMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Brown Health Center Current Accepting new patients
Howard Brown Health Center CurrentSince Mar 1, 2020 Accepting new patients
Howard Brown Health Center CurrentSince Mar 1, 2020 Accepting new patients
Howard Brown Health Center Past Accepting new patients

Locations

6500 N Clark St
Chicago, IL 60626
Phone (773) 681-5033

4025 N Sheridan Rd
Chicago, IL 60613
Phone (773) 388-1800

Interoperability endpoints

  • Direct secure messaging: mmoore581219@direct.ochin.org

Organizations & group practices 4

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1912914490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9119 S EXCHANGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174225",
            "telephone_number": "773-768-5000",
            "fax_number": "773-768-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 E 8TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052168",
            "telephone_number": "312-212-9000",
            "fax_number": "312-212-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MONICA",
        "middle_name": "ANNETTE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "036-096183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-096183",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.