MEDICARE: DR. BRIAN SCOTT MORSE MD, PHD

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	208000000X	Pediatrics Physician	036-103999	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447312889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN SCOTT MORSE MD, PHD

Provider Business Mailing Address
First Line	:	5240 N PULASKI RD
Second Line	:	STE E
City	:	CHICAGO
State	:	IL
Zip	:	60630-1761
Country	:	US
Telephone Number	:	773-883-1857
Fax Number	:

Provider Business Practice Location Address
First Line	:	5240 N PULASKI RD
Second Line	:	STE E
City	:	CHICAGO
State	:	IL
Zip	:	60630-1761
Country	:	US
Telephone Number	:	773-883-1857
Fax Number	:

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

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	01/15/2012

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