Healthcare Provider Details

I. General information

NPI: 1861447351
Provider Name (Legal Business Name): GARY J MORGAN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 N ROSELLE RD
HOFFMAN ESTATES IL
60195-3730
US

IV. Provider business mailing address

167 CAWDOR LN
INVERNESS IL
60067-8005
US

V. Phone/Fax

Practice location:
  • Phone: 847-885-2030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: