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General NPI Number Information
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NPI Number | 1013246289
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Entity Type | Organization
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Legal Business Name | JERI MORRIS, PH.D., P.C.
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Dates
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Enumeration Date | 12/16/2009
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Last Update Date | 12/16/2009
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Provider Practice Location Address
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Address Line | 60 REVERE DR SUITE 330
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City | NORTHBROOK
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State | IL
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Zip | 60062-1563
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Country | US
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Telephone | 847-432-9055
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Fax | 847-432-7787
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Provider Business Mailing Address
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Address Line | 395 BEECH ST
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-4133
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Country | US
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Telephone | 312-321-9443
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Fax | 847-432-7787
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JERI MORRIS
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Credential | CLINICAL PSYCHOLOGIS
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Telephone | 312-321-9443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071003104
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License Number State | IL
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