MEDICARE: MRS. RACHEL L. MORRIS OTR/L

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	225X00000X	Occupational Therapist	056004164	IL

General Provider Information

NPI Number	:	1831117175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RACHEL L. MORRIS OTR/L

Provider Business Mailing Address
First Line	:	2957 W LUNT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-2919
Country	:	US
Telephone Number	:	847-494-0442
Fax Number	:

Provider Business Practice Location Address
First Line	:	2957 W LUNT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-2919
Country	:	US
Telephone Number	:	847-494-0442
Fax Number	:

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	09/01/2011

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