Provider Demographics
NPI:1407086663
Name:MORLEY, KATHLEEN (DOCTOR OF OPTOMETRY)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:MORLEY
Suffix:
Gender:F
Credentials:DOCTOR OF OPTOMETRY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6116 N KILBOURN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5020
Mailing Address - Country:US
Mailing Address - Phone:773-484-7799
Mailing Address - Fax:
Practice Address - Street 1:7305 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-3547
Practice Address - Country:US
Practice Address - Phone:773-589-1935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010258152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist