Kathryn Mary Moe, PA-C
Physician Assistant in Evanston, IL. Individual provider (NPI-1).
NPI number1760107023
StatusActive
Last updated in NPPESSep 29, 2026
Details
- NPI
- 1760107023
- Entity type
- Individual (NPI-1)
- Name
- Kathryn Mary Moe
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 10, 2022
- Certification date
- Sep 29, 2026
- Last updated
- Sep 29, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085009284 | IL | Yes |
Practice location
2650 Ridge AveEvanston, IL 60201-1700
Phone 847-570-2475 · Fax 847-570-2942
Mailing address
2650 Ridge AveEvanston, IL 60201-1700
Phone 847-570-2475 · Fax 847-570-2942
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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