MEDICARE: MR. GARY STEPHAN MORROW R.PH.

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	183500000X	Pharmacist		IL

General Provider Information

NPI Number	:	1114044013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GARY STEPHAN MORROW R.PH.

Provider Business Mailing Address
First Line	:	1020 HOWARD ST
Second Line	:
City	:	SAINT CHARLES
State	:	IL
Zip	:	60174-2654
Country	:	US
Telephone Number	:	630-513-5661
Fax Number	:

Provider Business Practice Location Address
First Line	:	2063 LINCOLN HWY
Second Line	:
City	:	SAINT CHARLES
State	:	IL
Zip	:	60174-1580
Country	:	US
Telephone Number	:	630-584-2038
Fax Number	:	630-584-1017

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

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	07/08/2007

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