Provider Demographics
NPI:1114044013
Name:MORROW, GARY STEPHAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:STEPHAN
Last Name:MORROW
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2654
Mailing Address - Country:US
Mailing Address - Phone:630-513-5661
Mailing Address - Fax:
Practice Address - Street 1:2063 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1580
Practice Address - Country:US
Practice Address - Phone:630-584-2038
Practice Address - Fax:630-584-1017
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist