Healthcare Provider Details

I. General information

NPI: 1306787338
Provider Name (Legal Business Name): GEORGEOUS MORCOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4457 SOUTHWEST HWY STE 201
OAK LAWN IL
60453-3778
US

IV. Provider business mailing address

5744 N BROADWAY ST
CHICAGO IL
60660-4302
US

V. Phone/Fax

Practice location:
  • Phone: 708-598-2448
  • Fax:
Mailing address:
  • Phone: 847-881-5001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number297.011170
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: