Healthcare Provider Details

I. General information

NPI: 1922529627
Provider Name (Legal Business Name): KAREN MOSES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10400 HALIGUS RD
HUNTLEY IL
60142-9553
US

IV. Provider business mailing address

1200 W STATE ST
ROCKFORD IL
61102-2112
US

V. Phone/Fax

Practice location:
  • Phone: 815-356-2323
  • Fax: 847-802-7201
Mailing address:
  • Phone: 815-490-1600
  • Fax: 815-490-1881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD70056472
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036-157433
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD70056472
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: