Taneisha Moore

Primary specialty

Other TechnicianTaxonomy code 247200000X

Practice address

2829 W 87TH St
Evergreen Park, IL 60805-1135

Phone

(773) 370-3726

Fax

(773) 352-9492

NPI assigned

Jun 22, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• The Land of Her

  • Prosthetic/Orthotic Supplier
  • Evergreen Park, IL
  • NPI 1548904816
  NPD Authorized official

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1952032633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22829 OAKLAND DR",
            "city": "STEGER",
            "state": "IL",
            "postal_code": "604755933",
            "telephone_number": "773-370-3726",
            "fax_number": "773-352-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 W 87TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608051135",
            "telephone_number": "773-370-3726",
            "fax_number": "773-352-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TANEISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "7733529492",
            "affiliation": "N",
            "endpointDescription": "Fax",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2829 W 87th St",
            "city": "Evergreen Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "608051135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wynnette J. Moneka, M.A.
• Patrick Montag
• Michael John Montesano, DO
• Maria Anne Moore, O.D.
• Markeita R. Moore, M.D.
• Elizabeth Morales, MS, CF-SLP
• Virginia Morgan, APRN, CNP
• Katherine Lynn Moriarty, OTR/L
• Cynthia D Morris, APRN, CNP
• Thomas James Moss, DDS

• Other Technician in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Other Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.