Provider Demographics
NPI:1295850683
Name:MORRISON AND ASSOCIATES PEDIATRIC THERAPISTS, LLC
Entity Type:Organization
Organization Name:MORRISON AND ASSOCIATES PEDIATRIC THERAPISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:DOYLE
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTRL
Authorized Official - Phone:708-203-0569
Mailing Address - Street 1:531 N BRAINARD AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60526-5520
Mailing Address - Country:US
Mailing Address - Phone:708-203-0569
Mailing Address - Fax:
Practice Address - Street 1:531 N BRAINARD AVE
Practice Address - Street 2:
Practice Address - City:LA GRANGE PARK
Practice Address - State:IL
Practice Address - Zip Code:60526-5520
Practice Address - Country:US
Practice Address - Phone:708-203-0569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1634773OtherBLUE CROSS BLUE SHIELD