Healthcare Provider Details

I. General information

NPI: 1083005185
Provider Name (Legal Business Name): MORGAN FALLOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2015
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 S MARYLAND AVE # MC1052
CHICAGO IL
60637-1443
US

IV. Provider business mailing address

16430 N SCOTTSDALE RD STE 210
SCOTTSDALE AZ
85254-1581
US

V. Phone/Fax

Practice location:
  • Phone: 773-702-3858
  • Fax:
Mailing address:
  • Phone: 602-266-8700
  • Fax: 602-626-8901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number65417
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number036151969
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: