Andrea Moore

Clinical Social Worker · Calumet Park, IL

Individual Active NPI

NPI number 1578010435

Practice location

12446 S Loomis St
Calumet Park, IL 60827-5832
Phone
(773) 641-7095

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NPI record

NPI
1578010435
Entity type
Individual (Type 1)
Enumeration date
September 7, 2016
Last updated
September 7, 2016
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Clinical Social Worker Primary 1041C0700X 149.016158 IL

Mailing address

PO Box 53529
Chicago, IL 60653-0529
Phone
(773) 641-7095

About Andrea Moore

Andrea Moore is a healthcare provider registered in the NPI registry with the primary taxonomy Clinical Social Worker (code 1041C0700X). The practice location is 12446 S Loomis St, Calumet Park, IL 60827-5832. The NPI number 1578010435 was assigned on September 7, 2016 and the record was last updated on September 7, 2016.

Andrea Moore lists a license in the registry: #149.016158 (IL) for Clinical Social Worker. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Andrea Moore?

The NPI number is 1578010435.

What is the phone number of Andrea Moore?

The phone number listed for the practice location is (773) 641-7095.

Where is Andrea Moore located?

12446 S Loomis St, Calumet Park, IL 60827-5832.

What is the taxonomy code for Andrea Moore?

The primary taxonomy code is 1041C0700X – Clinical Social Worker.

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.