MEDICARE: PAULA LYNETTE MOORE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1639054992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA LYNETTE MOORE

Provider Business Mailing Address
First Line	:	7740 S KING DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60619-2929
Country	:	US
Telephone Number	:	773-814-9407
Fax Number	:

Provider Business Practice Location Address
First Line	:	715 W 51ST ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60609-5118
Country	:	US
Telephone Number	:	773-814-9407
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2025
Last Update Date	:	08/07/2025

Similar Medicare Providers

1154650067 — AMY I CATANIA
Practice Location Address:

1708 N FRANCISCO AVE
CHICAGO, IL
60647-5118

Practice Phone: 773-255-4542
Practice Fax:

1649779596 — KATARZYNA ANNA PORYS
Practice Location Address:

5118 S NORMANDY AVE
CHICAGO, IL
60638-1226

Practice Phone: 773-610-3220
Practice Fax:

1144928342 — MINNIE J COOKS
Practice Location Address:

11610 S ELIZABETH ST
CHICAGO, IL
60643-5118

Practice Phone: 773-440-3348
Practice Fax:

1295385490 — PCC COMMUNITY WELLNESS CENTER
Practice Location Address:

4534 S WESTERN AVE
CHICAGO, IL
60609-3027

Practice Phone: 708-406-3056
Practice Fax: 708-406-3051

1205834934 — DR. ROGELIO N LIBOON M.D.
Practice Location Address:

1937 W 35TH ST
CHICAGO, IL
60609-1206

Practice Phone: 773-523-8014
Practice Fax: 630-654-4362

1912997743 — DR. AHMED SHAFI M.D.
Practice Location Address:

4829 S ASHLAND AVE
CHICAGO, IL
60609-4234

Practice Phone: 773-927-2714
Practice Fax: 773-927-2716

Directions to “ PAULA LYNETTE MOORE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.