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General NPI Number Information
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NPI Number | 1366056731
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Entity Type | Individual
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Provider Name | MORGAN PROCTOR OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/03/2020
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | WEST SUBURBAN NURSING AND REHABILITATION 311 EDGEWATER DRIVE
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City | BLOOMINGDALE
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State | IL
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Zip | 60108
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Country | US
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Telephone | 630-984-7400
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Fax |
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Provider Business Mailing Address
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Address Line | FOREST VIEW NURSING AND REHABILITATION 535 S. ELM STREET
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City | ITASCA
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State | IL
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Zip | 60143
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Country | US
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Telephone | 630-773-9416
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 056.013600
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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