DR. ADAM MORENO (NPI# 1164045167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164045167 |
| Entity Type | Individual |
| Full Name | DR. ADAM MORENO |
| Credential | DO |
| Practice Address |
1300 Franklin Ave Ste 110 Normal IL 61761-3799 |
| Practice Telephone | 3092683502 |
| Mailing Telephone | 3092683502 |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2020-05-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 125.076721 | IL | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255758165 | Adam Moreno | Counselor | 2625 Zanker Rd., San Jose, CA 95134 | 2014-03-28 |
| Street Address |
1300 FRANKLIN AVE STE 110 |
| City | NORMAL |
| State | IL |
| Zip Code | 61761-3799 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467834317 | Karen Akemi Sung Putty | Family Medicine | 1300 Franklin Ave Ste 110, Normal, IL 61761-3799 | 2015-06-26 |
| 1669092938 | Colby Lee Carr | Student in an Organized Health Care Education/Training Program | 1300 Franklin Ave Ste 110, Normal, IL 61761-3799 | 2020-04-16 |
| 1316567613 | Joshua Pittman | Student in an Organized Health Care Education/Training Program | 1300 Franklin Ave Ste 110, Normal, IL 61761-3799 | 2020-04-16 |
| 1679103972 | Damian Olejarski | Student in an Organized Health Care Education/Training Program | 1300 Franklin Ave Ste 110, Normal, IL 61761-3799 | 2020-01-25 |
| 1881189215 | Nkeiruka Nwapa | Psychiatry & Neurology | 1300 Franklin Ave Ste 110, Normal, IL 61761-3799 | 2018-06-27 |
| 1336634237 | Nicholas Weber | Family Medicine | 1300 Franklin Ave Ste 110, Normal, IL 61761-3799 | 2018-06-25 |
| 1285154799 | Jordan Michael Forney | Family Medicine | 1300 Franklin Ave Ste 110, Normal, IL 61761-3799 | 2017-06-26 |
| 1932559119 | Ryan Michael Johnson | Neurological Surgery | 1300 Franklin Ave Ste 110, Normal, IL 61761-3799 | 2016-06-17 |
| 1669822318 | Bilal Ali Mohamed | Family Medicine | 1300 Franklin Ave Ste 110, Normal, IL 61761-3799 | 2016-06-14 |
| 1730536129 | Aaron Gustin | Student in an Organized Health Care Education/Training Program | 1300 Franklin Ave Ste 110, Normal, IL 61761-3799 | 2016-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1679108971 | Krystal Halliday | Occupational Therapist | 1815 N Towanda Barnes Rd, Normal, IL 61761 | 2020-03-06 |
| 1265915474 | Laine E Burek | Nurse Practitioner | 1765 Bradford Ln., Normal, IL 61761 | 2018-09-13 |
| 1801389986 | Ashley Michelle James | Specialist/Technologist | 347 S. University St, Normal, IL 61761 | 2018-06-12 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1497275069 | Mclean County Nursing Home | Non-emergency Medical Transport (VAN) | 901 N. Main St, Normal, IL 61761 | 2017-06-23 |
| 1235673666 | Megan Threm | Registered Nurse | 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 | 2016-12-04 |
| 1437513553 | Tiesha Smith | Specialist | 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 | 2016-04-06 |
| 1285031658 | New Day Recovery | Community/Behavioral Health | 402 Summit, Normal, IL 61761 | 2014-12-01 |
| 1174927701 | Alyssa Marie Bruck | Occupational Therapist | 700 N Walnut St, Normal, IL 61761 | 2014-10-10 |
| Find all providers in zip 61761 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606995 | Cassia Yuechun Weigel | Student in an Organized Health Care Education/Training Program | 601 N Main St Apt 5s, Normal, IL 61761-1576 | 2020-10-13 |
| 1912524703 | Cora Bennett | Student in an Organized Health Care Education/Training Program | 1109 E Shelbourne Dr, Normal, IL 61761-4860 | 2020-06-29 |
| 1013241793 | Quintin Hecht | Student in an Organized Health Care Education/Training Program | 211 Rachel Cooper Hl, Normal, IL 61790-4720 | 2009-09-28 |
| 1811122674 | Motoko Ugajin | Student in an Organized Health Care Education/Training Program | 711 S Cottage Ave Apt 103, Normal, IL 61761-4359 | 2009-05-22 |
| 1669092938 | Colby Lee Carr | Student in an Organized Health Care Education/Training Program | 1300 Franklin Ave Ste 110, Normal, IL 61761-3799 | 2020-04-16 |
| 1316567613 | Joshua Pittman | Student in an Organized Health Care Education/Training Program | 1300 Franklin Ave Ste 110, Normal, IL 61761-3799 | 2020-04-16 |
| 1679103972 | Damian Olejarski | Student in an Organized Health Care Education/Training Program | 1300 Franklin Ave Ste 110, Normal, IL 61761-3799 | 2020-01-25 |
| 1285196220 | Ondrea K Timmermann | Student in an Organized Health Care Education/Training Program | 1304 Franklin Ave, Normal, IL 61761-3558 | 2019-04-01 |
| 1841752854 | Uyen Thanh Pham Le | Student in an Organized Health Care Education/Training Program | 1304 Franklin Ave, Normal, IL 61761-3558 | 2019-04-01 |
| 1477013613 | Ahmad Emara | Student in an Organized Health Care Education/Training Program | 1304 Franklin Ave, Normal, IL 61761-3558 | 2019-03-22 |
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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.