Provider Demographics
NPI:1558039982
Name:THOMAS, MORGAN (DC)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16W343 83RD ST STE D
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7950
Mailing Address - Country:US
Mailing Address - Phone:630-908-7634
Mailing Address - Fax:630-568-3194
Practice Address - Street 1:16W343 83RD ST STE D
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-7950
Practice Address - Country:US
Practice Address - Phone:630-908-7634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013761111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor