Individual provider Active NPI

Moira Rachel Ford, RD, LDN

  • Registered Dietitian
  • Hanover Park, IL
National Provider Identifier
1962768465
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164004635 Issued in IL
Practice address
1875 Lucille LN
Hanover Park, IL 60133-5352
Phone
(630) 439-4884
NPI assigned
Apr 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164004635 IL Primary

Addresses

Primary practice location

1875 Lucille LN
Hanover Park, IL 60133-5352

Mailing address

1875 Lucille LN
Hanover Park, IL 60133-5352
Phone (630) 439-4884

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

LicenseStateTypeSpecialty
164004635ILMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1962768465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 LUCILLE LN",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "601335352",
            "telephone_number": "630-439-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 LUCILLE LN",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "601335352",
            "telephone_number": "630-439-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "MOIRA",
        "middle_name": "RACHEL",
        "name_prefix": "Ms.",
        "credential": "RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-09",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164004635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; 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.