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

Justin Richardson Moore, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1104679059

Justin Richardson Moore, MD is a Student in an Organized Health Care Education/Training Program in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2024.

Licensed in
IL
In the registry since
2024
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Chicago, IL

No coordinates on file. Search this address in Google Maps

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Family Medicine Physician Taxonomy 207Q00000X · Licence 125.085396 (IL)

Record details

NPI number1104679059
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 10, 2024
Last updated in NPPESMay 11, 2025
Certification dateMay 11, 2025

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