Healthcare Provider Details

I. General information

NPI: 1033498258
Provider Name (Legal Business Name): MICHAEL TROY MORLEY MPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2011
Last Update Date: 08/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1406 E ALGONQUIN RD
ALGONQUIN IL
60102-4290
US

IV. Provider business mailing address

1406 E ALGONQUIN RD
ALGONQUIN IL
60102-4290
US

V. Phone/Fax

Practice location:
  • Phone: 847-854-0196
  • Fax: 847-854-0197
Mailing address:
  • Phone: 847-854-0196
  • Fax: 847-854-0197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.018674
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: