MEDICARE: MRS. DANA MORGAN MS CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	146012825	IL

General Provider Information

NPI Number	:	1528573359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANA MORGAN MS CCC-SLP

Provider Business Mailing Address
First Line	:	211 S DORCHESTER AVE
Second Line	:
City	:	WHEATON
State	:	IL
Zip	:	60187-4711
Country	:	US
Telephone Number	:	630-373-9613
Fax Number	:

Provider Business Practice Location Address
First Line	:	162 S YORK ST
Second Line	:
City	:	ELMHURST
State	:	IL
Zip	:	60126-3417
Country	:	US
Telephone Number	:	630-834-4530
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2017
Last Update Date	:	12/01/2017

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