MEDICARE: MOORE HOPE CLINICAL SERVICES PC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1821952946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOORE HOPE CLINICAL SERVICES PC

Provider Business Mailing Address
First Line	:	9631 W 153RD ST STE 33
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60462-3778
Country	:	US
Telephone Number	:	630-800-9905
Fax Number	:

Provider Business Practice Location Address
First Line	:	9631 W 153RD ST STE 33
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60462-3778
Country	:	US
Telephone Number	:	630-800-9905
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	LAURA MOORE
Credential	:	PSYD
Telephone Number	:	630-800-9905

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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