Healthcare Provider Details

I. General information

NPI: 1932439361
Provider Name (Legal Business Name): MORGAN WALSH OTR/L, CLT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2010
Last Update Date: 03/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 N HALSTED ST STE 525
CHICAGO IL
60657-9269
US

IV. Provider business mailing address

3000 N HALSTED ST STE 525
CHICAGO IL
60657-9269
US

V. Phone/Fax

Practice location:
  • Phone: 773-433-3130
  • Fax: 773-433-3127
Mailing address:
  • Phone: 773-433-3130
  • Fax: 773-433-3127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: