Tanisha Moore

Physician Assistant · Wilmette, IL

Individual Active NPI

NPI number 1558069542

Practice location

311a Ridge Rd Apt 113
Wilmette, IL 60091-3256
Phone
(267) 505-6106

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NPI record

NPI
1558069542
Entity type
Individual (Type 1)
Enumeration date
February 20, 2023
Last updated
July 23, 2024
Certified
July 23, 2024
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 085-009934 IL

About Tanisha Moore

Tanisha Moore is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 311a Ridge Rd Apt 113, Wilmette, IL 60091-3256. The NPI number 1558069542 was assigned on February 20, 2023 and the record was last updated on July 23, 2024.

Tanisha Moore lists a license in the registry: #085-009934 (IL) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Tanisha Moore?

The NPI number is 1558069542.

What is the phone number of Tanisha Moore?

The phone number listed for the practice location is (267) 505-6106.

Where is Tanisha Moore located?

311a Ridge Rd Apt 113, Wilmette, IL 60091-3256.

What is the taxonomy code for Tanisha Moore?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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