Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 036108676 | IL |
N | 208600000X | Surgeon | 036108676 | IL |
N | 208200000X | Surgeon | 036108676 | IL |
N | 208600000X | Surgeon | 036108676 | IL |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 036108676 | IL |
NPI | 1174663413 |
---|---|
Provider Name | Dr. David Morris |
First Address | Chicago, IL 60612-4325 |
Second Address | Chicago, IL 60612-7232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 17/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036.108676 | (05) | IL |