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

Nycole Moore

Individual provider Family Nurse Practitioner · NPI 1760365753

Nycole Moore is a Nurse Practitioner in Chicago, Illinois. Qualified in 2024, 2 years ago. Licensed in Illinois.

Years since qualifying
2
Licensed in
IL
In the registry since
2025

Practice location Address checks out

5401 S Wentworth Ave
Chicago, IL 60609-6300
Phone: (773) 288-6900
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 209031400 (IL)

Record details

NPI number1760365753
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorNo
NPI enumeratedJuly 28, 2025
Last updated in NPPESJuly 28, 2025
Certification dateJuly 28, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated

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