Provider Demographics
NPI:1033534086
Name:MORRIS, SHERRI (OD)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 W HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-1615
Mailing Address - Country:US
Mailing Address - Phone:618-632-3195
Mailing Address - Fax:618-632-4083
Practice Address - Street 1:1350 W HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-1615
Practice Address - Country:US
Practice Address - Phone:618-632-3195
Practice Address - Fax:618-632-4083
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.008587152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist