Healthcare Provider Details

I. General information

NPI: 1205561701
Provider Name (Legal Business Name): MORGAN O'HARA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15003 S ROUTE 59
PLAINFIELD IL
60544-2730
US

IV. Provider business mailing address

284 PAINE ST
SOUTH ELGIN IL
60177-3221
US

V. Phone/Fax

Practice location:
  • Phone: 630-519-1010
  • Fax: 630-405-7209
Mailing address:
  • Phone: 847-401-6429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178013276
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: