MEDICARE: DONNA MORALES LPT

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1811911159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA MORALES LPT

Provider Business Mailing Address
First Line	:	100 E IRVING PARK RD
Second Line	:	STE. #107
City	:	ROSELLE
State	:	IL
Zip	:	60172-2048
Country	:	US
Telephone Number	:	630-439-0009
Fax Number	:	630-439-0011

Provider Business Practice Location Address
First Line	:	1170 PARK AVE W
Second Line	:
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-2203
Country	:	US
Telephone Number	:	847-433-3700
Fax Number	:	847-433-1699

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	11/12/2025

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