Healthcare Provider Details
I. General information
NPI: 1720185150
Provider Name (Legal Business Name): MORRIS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/20/2006
Last Update Date: 09/01/2023
Certification Date: 09/01/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 W US ROUTE 6
MORRIS IL
60450
US
IV. Provider business mailing address
725 SCHOOL ST STE A
MORRIS IL
60450-1207
US
V. Phone/Fax
- Phone: 815-942-2932
- Fax: 815-941-0743
- Phone: 815-941-9124
- Fax: 815-941-4363
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QX0203X |
| Taxonomy | Radiation Oncology Clinic/Center |
| License Number | 0001628 |
| License Number State | IL |
VIII. Authorized Official
Name:
MICHAEL
LAWRENCE
Title or Position: CFO
Credential:
Phone: 815-942-2932