Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Mary Ellen Moore, PHD

Individual provider Clinical Psychologist · NPI 1487735940

Dr. Mary Ellen Moore, PHD is a Clinical Psychologist in Chicago, Illinois. Qualified in 1975, 51 years ago. Accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
51
Licensed in
IL
In the registry since
2006
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

2648 W Pershing Rd
Chicago, IL 60632-1629
Phone: (312) 806-1885
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 071002095 (IL)

Record details

NPI number1487735940
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorNo
NPI enumeratedOctober 18, 2006
Last updated in NPPESMay 20, 2020
Certification dateMay 20, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1975 (51 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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