Healthcare Provider Details

I. General information

NPI: 1295626729
Provider Name (Legal Business Name): MORGAN M MCDOWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2025
Last Update Date: 07/12/2025
Certification Date: 07/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424 N 8TH ST
PEKIN IL
61554-1547
US

IV. Provider business mailing address

2424 N 8TH ST
PEKIN IL
61554-1547
US

V. Phone/Fax

Practice location:
  • Phone: 309-382-6404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number020.016036
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: