Healthcare Provider Details

I. General information

NPI: 1043905508
Provider Name (Legal Business Name): KELLY R. MORRIS DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KELLY RAE ADAMS

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S YORK ST STE 2000
ELMHURST IL
60126-5634
US

IV. Provider business mailing address

4201 WINFIELD RD FL 3
WARRENVILLE IL
60555-4025
US

V. Phone/Fax

Practice location:
  • Phone: 331-221-9003
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209025920
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209025920
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: