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

Mary Ellen Moore, DO

Individual provider Family Medicine Physician · NPI 1730434879

Mary Ellen Moore, DO is a Family Practice in Oak Lawn, Illinois. Graduated from Kansas City Medical College in 2012, 14 years ago. Practices with Lawn Medical Center, SC, an 11-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
14
Trained at
Kansas City Medical College
Licensed in
IL
In the registry since
2012
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

4301 W 95th St Ste 1
Oak Lawn, IL 60453-2698
Phone: (708) 425-5500
Fax: (708) 425-0771
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 125.061971 (IL)

Record details

NPI number1730434879
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 15, 2012
Last updated in NPPESDecember 28, 2021
Certification dateDecember 28, 2021
Mailing address4140 Southwest Hwy, Hometown, IL 60456-1135

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolKANSAS CITY MEDICAL COLLEGE
Graduated 2012 (14 years in practice)
Group practice Lawn Medical Center, S.C. — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Oak Lawn