DR. NICHOLAS M MOORE PHD
NPI 1073017679
Pathology - Clinical Laboratory Director, Non-physician in Chicago, IL

Q: What is Nicholas Moore's NPI number?

The NPI number for Nicholas Moore is 1073017679. It was assigned to this individual provider in the NPPES registry on March 20, 2018.

Q: What is Nicholas Moore's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Clinical Laboratory Director, Non-physician, with taxonomy code 247ZC0005X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Moore was last updated on March 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 20, 2018

1653 W CONGRESS PKWY STE 1173, CHICAGO, IL 60612(312) 942-3214(312) 942-6787 Get Directions Write a Review

NPPES record last updated: March 20, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Nicholas M Moore Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICHOLAS M MOORE PHD (NPI 1073017679) is an individual clinical laboratory director, non-physician in Chicago, Illinois and active in the NPI registry since March 2018.

NPPES Registry Identity

NPI1073017679

Entity TypeIndividualMale

Primary Taxonomy247ZC0005X

Provider Legal NameDR. NICHOLAS M MOORECredential: PHD

Location Address1653 W CONGRESS PKWY STE 1173Chicago, IL 60612-3833

Mailing Address1653 W Congress Pkwy Ste 1173Chicago, IL 60612-3833 · (312) 942-3214 · Fax (312) 942-6787

Phone(312) 942-3214

Fax(312) 942-6787

Sole ProprietorNo

Enumeration DateMarch 20, 2018

✔ NPI 1073017679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPathology · Clinical Laboratory Director, Non-physicianTechnologists, Technicians & Other Technical Service Providers

Taxonomy Code247ZC0005X

Definition

An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405.

Also ListedSpecialist/Technologist, Pathology · Medical TechnologistTaxonomy 246QM0706X

1653 W CONGRESS PKWY STE 1173, Chicago, IL 60612

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholas Moore's NPI number?

The NPI number for Nicholas Moore is 1073017679. It was assigned to this individual provider in the NPPES registry on March 20, 2018.

Where is Nicholas Moore located?

Nicholas Moore practices at 1653 W Congress Pkwy Ste 1173, Chicago, IL 60612. The listed phone number is (312) 942-3214.

What is Nicholas Moore's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Clinical Laboratory Director, Non-physician, with taxonomy code 247ZC0005X.

When was this NPI record last updated?

The NPPES record for Nicholas Moore was last updated on March 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.