Provider Demographics
NPI:1407502065
Name:MORALES, AARON (OSC)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:MORALES
Suffix:
Gender:M
Credentials:OSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 W POLK ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3723
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1950 W POLK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3723
Practice Address - Country:US
Practice Address - Phone:312-864-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FX1202X, 156FX1100X, 156FX1800X, 246Z00000X
IL2618702174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No156FX1202XEye and Vision Services ProvidersTechnician/TechnologistOptometric Technician
No156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
No174H00000XOther Service ProvidersHealth Educator