Individual ProviderEdith MoranSocial WorkerBehavioral Health & Social Service ProvidersPractice Address4000 W Montrose Ave # 528, Chicago, IL 60641-2140(312) 835-7286PECOS EnrollmentBased on the most recent information from CMS, provider Edith Moran is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1972150712Provider TypeIndividualFull NameMoran, EdithCredentialLCSWGenderFemaleSole ProprietorYesEnumeration Date8/26/2019Last Updated7/23/2025Contact InformationPractice LocationPractice Address4000 W Montrose Ave # 528, Chicago, IL 60641-2140Phone(312) 835-7286FaxUnlisted FaxMailing LocationMailing Address4000 W Montrose Ave # 528, Chicago, IL 60641-2140Phone(312) 835-7286FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense149.019579Illinois