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NPI Code Detail

MEDICARE: DR. TIMOTHY J. MORRISON O.D.

MEDICARE:  DR. TIMOTHY J. MORRISON  O.D.
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
1152W00000XOptometrist046008092IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
116084438OTHERILBLUECROSSBLUESHIELD

General Provider Information

NPI Number : 1023065000
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY J. MORRISON O.D.
Provider Business Mailing Address
First Line : 8605 W 95TH ST
Second Line :
City : HICKORY HILLS
State : IL
Zip : 60457-2704
Country : US
Telephone Number : 708-599-9095
Fax Number : 708-233-9866
Provider Business Practice Location Address
First Line : 8605 W 95TH ST
Second Line :
City : HICKORY HILLS
State : IL
Zip : 60457-2704
Country : US
Telephone Number : 708-599-9095
Fax Number : 708-233-9866
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2006
Last Update Date : 02/06/2015

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