Provider Demographics
NPI:1063471993
Name:MORNINGSTAR, ANDREW L (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:L
Last Name:MORNINGSTAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843
Mailing Address - Street 2:
Mailing Address - City:GLEN CARBON
Mailing Address - State:IL
Mailing Address - Zip Code:62034-0843
Mailing Address - Country:US
Mailing Address - Phone:618-288-8090
Mailing Address - Fax:618-288-4422
Practice Address - Street 1:3733 S STATE ROUTE 159
Practice Address - Street 2:
Practice Address - City:GLEN CARBON
Practice Address - State:IL
Practice Address - Zip Code:62034-3043
Practice Address - Country:US
Practice Address - Phone:618-288-8090
Practice Address - Fax:618-288-4422
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
393390OtherHEALTHLINK
666140OtherUHC
U72160OtherMERCY
IL06032118OtherBCBS ILLINOIS
MO167548OtherBCBS MISSOURI
1946821OtherFIRST HEALTH
231924OtherGHP
IL06032118OtherBCBS ILLINOIS
666140OtherUHC