Healthcare Provider Details

I. General information

NPI: 1700986742
Provider Name (Legal Business Name): MORRIS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 12/24/2019
Certification Date: 12/24/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W US ROUTE 6
MORRIS IL
60450-8854
US

IV. Provider business mailing address

725 SCHOOL ST STE A
MORRIS IL
60450-1207
US

V. Phone/Fax

Practice location:
  • Phone: 815-942-2932
  • Fax: 815-941-0743
Mailing address:
  • Phone: 815-941-9124
  • Fax: 815-941-4363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number0001628
License Number StateIL

VIII. Authorized Official

Name: MARK STEADHAM
Title or Position: PRESIDENT & CEO
Credential:
Phone: 815-942-2932