=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891974234
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MORRIS MARC SORIANO MD LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/02/2007
-----------------------------------------------------
Last Update Date | 01/24/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 973 FEATHERSTONE RD SUITE360
-----------------------------------------------------
City | ROCKFORD
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61107-5912
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-395-1991
-----------------------------------------------------
Fax | 815-395-1994
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 973 FEATHERSTONE RD SUITE360
-----------------------------------------------------
City | ROCKFORD
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61107-5912
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-395-1991
-----------------------------------------------------
Fax | 815-395-1994
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | MORRIS MARC SORIANO
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 815-395-1991
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207T00000X
-----------------------------------------------------
Taxonomy Name | Neurological Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------