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

Moshini Sivasubramaniam

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1720491467

Moshini Sivasubramaniam is a Family Practice in Chicago, Illinois. Graduated from Loyola University of Chicago, Stritch School of Medicine in 2014, 12 years ago. Practices with Pcc Community Wellness Center, a 89-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
12
Trained at
Loyola University of Chicago, Stritch School of Medicine
Licensed in
IL
In the registry since
2014
Specialties on file
2
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Practice location Address checks out

5359 W Fullerton Ave
Chicago, IL 60639
Phone: (773) 836-7381
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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 036143417 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1720491467
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 10, 2014
Last updated in NPPESJanuary 2, 2020
Certification dateJanuary 2, 2020

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolLOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Graduated 2014 (12 years in practice)
Group practice Pcc Community Wellness Center — 89 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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