Healthcare Provider Details

I. General information

NPI: 1518881077
Provider Name (Legal Business Name): BETTY A MORRISON CLS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 PAXTON AVE
CALUMET CITY IL
60409-3129
US

IV. Provider business mailing address

503 PAXTON AVE
CALUMET CITY IL
60409-3129
US

V. Phone/Fax

Practice location:
  • Phone: 845-532-4226
  • Fax:
Mailing address:
  • Phone: 845-532-4226
  • Fax: 312-428-6413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: