Provider Demographics
NPI:1497734370
Name:MORROW, VERBAL ARTHUR (PT)
Entity Type:Individual
Prefix:
First Name:VERBAL
Middle Name:ARTHUR
Last Name:MORROW
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 W WALNUT ST
Mailing Address - Street 2:#2
Mailing Address - City:JACKSONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62650-1143
Mailing Address - Country:US
Mailing Address - Phone:217-245-1455
Mailing Address - Fax:217-243-6903
Practice Address - Street 1:1440 W WALNUT ST
Practice Address - Street 2:#2
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-1143
Practice Address - Country:US
Practice Address - Phone:217-245-1455
Practice Address - Fax:217-243-6903
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070001596225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL216653OtherPTAN FOR GROUP
IL$$$$$$$$$001Medicaid
IL216653OtherPTAN FOR GROUP
IL$$$$$$$$$001Medicaid