Provider Demographics
NPI:1073798773
Name:MORFOOT, CHARLENE (OD)
Entity Type:Individual
Prefix:DR
First Name:CHARLENE
Middle Name:
Last Name:MORFOOT
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 1:10880 N IL ROUTE 47
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-9717
Mailing Address - Country:US
Mailing Address - Phone:847-961-2020
Mailing Address - Fax:847-961-2345
Practice Address - Street 1:10880 N IL ROUTE 47
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-9717
Practice Address - Country:US
Practice Address - Phone:847-961-2020
Practice Address - Fax:847-961-2345
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-01
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0046010057152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist