Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 036.143336 | IL |
NPI | 1174936884 |
---|---|
Provider Name | Dr. Raymond Morales |
First Address | Chicago, IL 60612-3800 |
Second Address | Chicago, IL 60612-3800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2014 |
Last Update Date | 12/07/2019 |