Provider Demographics
NPI:1306002902
Name:MOREY, JUDITH ANNE (RN,BSN,CWOCN,APN)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANNE
Last Name:MOREY
Suffix:
Gender:F
Credentials:RN,BSN,CWOCN,APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 ORLAND SQUARE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-6548
Mailing Address - Country:US
Mailing Address - Phone:708-226-9055
Mailing Address - Fax:708-226-9054
Practice Address - Street 1:60 ORLAND SQUARE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-6548
Practice Address - Country:US
Practice Address - Phone:708-226-9055
Practice Address - Fax:708-226-9054
Is Sole Proprietor?:No
Enumeration Date:2008-08-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.002068364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041204911Medicaid