Angela Moore
Individual provider Active NPI Behavior Technician · Genoa, IL
NPI 1992256309 · NPPES record last updated Jul 22, 2025
Key facts
- NPI
- 1992256309
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 519 W 2ND St
Genoa, IL 60135-1058 - Phone
- (815) 517-3101
- NPI assigned
- Oct 20, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | IL | Yes |
Addresses
Primary practice location
519 W 2ND St
Genoa, IL 60135-1058
Mailing address
507 W Main St Apt 1
Kirkland, IL 60146-8453
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588395362 | Medicaid | IL |
Other providers in Genoa, IL
- Jill Lang
- Julie Renee Long
- Martine Lyle
- Julie Mensching
- Donald T. Miller Jr.
- Natural Family Health S.C.
- Northern Rehabilitation and Sports Medicine Associates
- Patricia Maria Pasillas Cardenas
- Sherie Anne Perdue
- Jean Michelle Reiss
All providers in Genoa, IL · Behavior Technician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.