DR. SAMUEL MORENO (NPI# 1568455236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568455236 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL MORENO |
| Credential | PHD |
| Practice Address |
4600 3rd St Moline IL 61265-6106 |
| Mailing Address |
4602 3rd St Moline IL 61265-6106 |
| Practice Telephone | 3097797552 |
| Mailing Telephone | 3097792031 |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | JOHN DEERE NUMBER | IL01A6 | 01 |
| IL | BLUE CROSS ILLINOIS | 71003237 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467574939 | Samuel Moreno | Case Manager/Care Coordinator | 1200 Wilshire Blvd Ste 500, Los Angeles, CA 90017-1934 | 2007-04-04 |
| Street Address |
4600 3RD ST |
| City | MOLINE |
| State | IL |
| Zip Code | 61265-6106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609870351 | Ernest Lee Galbreath | Psychiatry & Neurology | 4600 3rd St, Moline, IL 61265-6106 | 2005-06-10 |
| 1316545601 | Tamelia Abbasi | Nurse's Aide | 4600 3rd St, Moline, IL 61265-6106 | 2020-10-09 |
| 1346856556 | Alexa Stombaugh | Case Manager/Care Coordinator | 4600 3rd St, Moline, IL 61265-6106 | 2020-09-22 |
| 1639785454 | Tracy Lynn Petersen | Case Manager/Care Coordinator | 4600 3rd St, Moline, IL 61265-6106 | 2020-09-17 |
| 1609489806 | Parneet Sahota | Student in an Organized Health Care Education/Training Program | 4600 3rd St, Moline, IL 61265-6106 | 2020-08-26 |
| 1477162212 | Camille Katrina Butler | Technician | 4600 3rd St, Moline, IL 61265-6106 | 2020-07-28 |
| 1659901106 | Gloria Maria Guillen | Nurse Practitioner | 4600 3rd St, Moline, IL 61265-6106 | 2020-01-23 |
| 1699305136 | Kaila Jenaman | Nurse Practitioner | 4600 3rd St, Moline, IL 61265-6106 | 2020-01-23 |
| 1114567559 | Salena Hutchins | Nurse's Aide | 4600 3rd St, Moline, IL 61265-6106 | 2020-01-14 |
| 1619516218 | Jenifer Regennitter | Counselor | 4600 3rd St, Moline, IL 61265-6106 | 2019-12-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861035438 | Ora Orthopedics, PC | Orthopaedic Surgery | 510 Valley View Drive, Moline, IL 61265 | 2019-10-25 |
| 1598231698 | Secure Dental Vi | Dentist | 106 16th St, Unit #90, Moline, IL 61265 | 2018-10-17 |
| 1487152088 | Fjellheim P.c | Chiropractor | 1535 47th Avenue, Suite 5, Moline, IL 61265 | 2018-01-29 |
| 1326567199 | Elizabeth Ann Teichler | Respiratory Therapist, Registered | 4360 7th Street, Moline, IL 61265 | 2017-09-13 |
| 1497279913 | Caroline M Mather | Behavioral Analyst | 2430 6th Avenue, Moline, IL 61265 | 2017-07-26 |
| 1639625239 | Elizabeth Anderson | Nurse's Aide | 4319 26th Ave Apt 1, Moline, IL 61265 | 2016-09-01 |
| 1437604154 | Lindsey Bollaert | Nurse Practitioner | 1100 36th Ave, Moline, IL 61265 | 2016-08-23 |
| 1437541869 | Divvymed, LLC | Pharmacy | 4300 44th Ave, Moline, IL 61265 | 2015-02-23 |
| 1477955250 | Todd Stone | Nurse Practitioner | 1100 3th Avenue, Moline, IL 61265 | 2014-09-23 |
| 1588084479 | Familia Dental Moline LLC | Dentist | 1102 4th Ave, Moline, IL 61265 | 2014-04-18 |
| Find all providers in zip 61265 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306929690 | Rebecca S. Morgan | Psychologist | 2101 47th St, Moline, IL 61265-3663 | 2006-10-23 |
| 1437242773 | Kirk Witherspoon | Psychologist | 722 23rd Avenue Ct, Moline, IL 61265-4624 | 2006-10-01 |
| 1093795254 | Richard Arthur Hutchison | Psychologist | 3919 16th St, Moline, IL 61265-7217 | 2006-01-21 |
| 1588662126 | John Cunningham Brooke | Psychologist | 4324 7th St, Moline, IL 61265-6867 | 2005-07-08 |
| 1598954588 | Zhujun Jiang | Psychologist | 3816 27th St, Moline, IL 61265-6343 | 2007-10-16 |
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|---|---|---|---|---|
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| 1104426170 | Grace Giedgowd | Psychologist | 1640 W Division St Apt 205, Chicago, IL 60622-3939 | 2020-10-29 |
| 1417556283 | Kjp Alliance LLC | Psychologist | 16595 W Easton Ave Ste 1, Lincolnshire, IL 60069-2744 | 2020-10-22 |
| 1184223364 | Caroline Elisabeth Fulton | Psychologist | 1739 N Elston Ave, Chicago, IL 60642-1544 | 2020-10-20 |
| 1881293108 | Haley Michelle Sims | Psychologist | 65 E Wacker Pl Ste 300, Chicago, IL 60601-7203 | 2020-10-19 |
| 1083212005 | Amanda Michele Long | Psychologist | 20280 Governors Hwy Ste 105, Olympia Fields, IL 60461-1068 | 2020-10-12 |
| 1285231936 | Qianhui Zhang | Psychologist | 1225 W Morse Ave Apt 403, Chicago, IL 60626-5751 | 2020-10-06 |
| 1316544158 | Nancy Marie Picard | Psychologist | 4885 N Hermitage Ave, Chicago, IL 60640-4104 | 2020-10-05 |
| 1558978379 | Youngok Kim | Psychologist | 1260 Iroquois Ave Ste 204, Naperville, IL 60563-8548 | 2020-09-25 |
| 1861007049 | Heloisa Garman | Psychologist | 800 Elgin Rd Apt 1611, Evanston, IL 60201-5632 | 2020-09-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.