MEDICARE: DR. HERMAN LEO MORGAN 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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	036044069	IL

General Provider Information

NPI Number	:	1871671248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERMAN LEO MORGAN M.D.

Provider Business Mailing Address
First Line	:	9133 S STONY ISLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-3512
Country	:	US
Telephone Number	:	773-933-5511
Fax Number	:	773-933-5589

Provider Business Practice Location Address
First Line	:	9133 S STONY ISLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-3512
Country	:	US
Telephone Number	:	773-933-5511
Fax Number	:	773-933-5589

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	08/07/2012

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