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NPI Code Detail

MEDICARE: JENNY MOY NP

MEDICARE: JENNY MOY NP
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
1363L00000XNurse Practitioner209029218IL
2163W00000XRegistered Nurse041441989IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1209029218OTHERILDEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

General Provider Information

NPI Number : 1396521159
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNY MOY NP
Provider Business Mailing Address
First Line : 1653 W CONGRESS PKWY
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3833
Country : US
Telephone Number : 312-947-0100
Fax Number :
Provider Business Practice Location Address
First Line : 1653 W CONGRESS PKWY
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3833
Country : US
Telephone Number : 312-947-0100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2023
Last Update Date : 05/21/2026

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