Tanisha Moore
Tanisha Moore is a Physician Assistant in Chicago, Illinois. Practices as a sole proprietor. Licensed in Illinois.
- Licensed in
- IL
- In the registry since
- 2023
Practice location Address checks out
17 N State St Fl 5Chicago, IL 60602-3384
Phone: (312) 592-6800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 085-009934 (IL) |
|---|
Record details
| NPI number | 1558069542 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | February 20, 2023 |
| Last updated in NPPES | October 2, 2026 |
| Certification date | October 2, 2026 |
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