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General NPI Number Information
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NPI Number | 1487958096
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Entity Type | Organization
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Legal Business Name | HERMAN L MORGAN M.D.S.C.
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Dates
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Enumeration Date | 12/23/2010
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 9133 STONY ISLANDAVE
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City | CHICAGO
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State | IL
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Zip | 60617-3512
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Country | US
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Telephone | 773-933-5511
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Fax | 773-933-5589
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Provider Business Mailing Address
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Address Line | 9133 S STONY ISLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60617-3512
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Country | US
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Telephone | 773-933-5511
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HERMAN L MORGAN
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Credential | M.D.
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Telephone | 773-933-5511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036044069
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License Number State | IL
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