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

Mr. Tavares Moore

Individual provider Social Worker · NPI 1033627526

Mr. Tavares Moore is a Clinical Social Worker in Rockford, Illinois. Qualified in 2009, 17 years ago. Practices with Renita Shores-Gaston, a 6-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
17
Licensed in
IL
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

816 Featherstone Rd
Rockford, IL 61107-6300
Phone: (815) 227-0081
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 149015884 (IL)
Social Worker Taxonomy 104100000X · Licence 149.015884 (IL)

Record details

NPI number1033627526
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 18, 2018
Last updated in NPPESJanuary 26, 2023
Certification dateJanuary 26, 2023
Mailing address4202 Dunbar Pl, Rockford, IL 61114-6117

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Renita Shores-Gaston — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Rockford