Tanisha Moore, is a
Physician Assistant based in Wilmette, Illinois. Tanisha Moore is licensed to practice in Illinois (license number 085-009934) and her current practice location is
311a Ridge Rd Apt 113, Wilmette, Illinois. She can be reached at her office (for appointments etc.) via phone at
(267) 505-6106.
NPI number for Tanisha Moore is 1558069542 and her current mailing address is 311a Ridge Rd Apt 113, Wilmette, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1558069542.
Provider's Profile
Full Name | Tanisha Moore |
---|
Gender | Female |
---|
Speciality | Physician Assistant |
---|
Location | 311a Ridge Rd Apt 113, Wilmette, Illinois |
---|
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1558069542
- Provider Enumeration Date: 02/20/2023
- Last Update Date: 07/23/2024
Medical Identifiers
Medical identifiers for Tanisha Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1558069542 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | 085-009934 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tanisha Moore is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Tanisha Moore, 311a Ridge Rd Apt 113, Wilmette, IL 60091-3256 Ph: (267) 505-6106 | Tanisha Moore, 311a Ridge Rd Apt 113, Wilmette, IL 60091-3256 Ph: (267) 505-6106 |
Reviews and Comments