Provider Demographics
NPI:1417918913
Name:IEHL-MORSE, KAREN ANNETTE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ANNETTE
Last Name:IEHL-MORSE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 ASTER DR
Mailing Address - Street 2:
Mailing Address - City:SAVOY
Mailing Address - State:IL
Mailing Address - Zip Code:61874-9593
Mailing Address - Country:US
Mailing Address - Phone:217-352-2109
Mailing Address - Fax:
Practice Address - Street 1:1402 S 1ST ST
Practice Address - Street 2:TRAINING ROOM, MEMORIAL STADIUM
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-6916
Practice Address - Country:US
Practice Address - Phone:217-333-7702
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer