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NPI Code Detail

MEDICARE: ALAN MORRIS M.D.

MEDICARE: ALAN MORRIS M.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
12084P0804XChild & Adolescent Psychiatry PhysicianIL

General Provider Information

NPI Number : 1720090970
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALAN MORRIS M.D.
Provider Business Mailing Address
First Line : 912 S WOOD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4300
Country : US
Telephone Number : 312-996-7206
Fax Number : 312-996-9788
Provider Business Practice Location Address
First Line : 1747 W ROOSEVELT RD
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1264
Country : US
Telephone Number : 312-996-7223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2006
Last Update Date : 07/08/2007

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