MEDICARE: LATANYA MORRIS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	085004271	IL

General Provider Information

NPI Number	:	1013258110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATANYA MORRIS PA-C

Provider Business Mailing Address
First Line	:	2813 W 147TH ST
Second Line	:
City	:	POSEN
State	:	IL
Zip	:	60469-1516
Country	:	US
Telephone Number	:	708-396-9777
Fax Number	:	708-396-9732

Provider Business Practice Location Address
First Line	:	2813 W 147TH ST
Second Line	:
City	:	POSEN
State	:	IL
Zip	:	60469-1516
Country	:	US
Telephone Number	:	708-396-9777
Fax Number	:	708-396-9732

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2013
Last Update Date	:	03/14/2013

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Directions to “ LATANYA MORRIS PA-C” Practice Location

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