Healthcare Provider Details

I. General information

NPI: 1811964745
Provider Name (Legal Business Name): RANDY S MORRIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 09/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 N. WASHINGTON ST.
NAPERVILLE IL
60540
US

IV. Provider business mailing address

3 N WASHINGTON ST FL 2
NAPERVILLE IL
60540-4780
US

V. Phone/Fax

Practice location:
  • Phone: 630-357-6540
  • Fax: 630-357-6435
Mailing address:
  • Phone: 630-357-6540
  • Fax: 630-357-6435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number036081298
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: