Healthcare Provider Details

I. General information

NPI: 1003312059
Provider Name (Legal Business Name): THOMAS JAMES MCMORROW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2018
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 NE GLEN OAK AVE
PEORIA IL
61637-1334
US

IV. Provider business mailing address

1173 SUNSET DR
EAST PEORIA IL
61611-1167
US

V. Phone/Fax

Practice location:
  • Phone: 309-655-2553
  • Fax: 309-655-2602
Mailing address:
  • Phone: 412-638-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036169538
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number036169538
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: