Provider Demographics
NPI:1164179479
Name:MORRIS HOSPITAL
Entity Type:Organization
Organization Name:MORRIS HOSPITAL
Other - Org Name:MORRIS HOSPITAL & HEALTHCARE CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-705-1430
Mailing Address - Street 1:725 SCHOOL ST STE A
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-1207
Mailing Address - Country:US
Mailing Address - Phone:815-941-9124
Mailing Address - Fax:815-941-4363
Practice Address - Street 1:1450 E DIVISION ST
Practice Address - Street 2:
Practice Address - City:DIAMOND
Practice Address - State:IL
Practice Address - Zip Code:60416-6050
Practice Address - Country:US
Practice Address - Phone:815-634-3500
Practice Address - Fax:815-705-1718
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MORRIS HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-07
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL001628Medicaid
IL177OtherBC/BS