Provider Demographics
NPI:1598059982
Name:MORKER, MAYURI (MD)
Entity Type:Individual
Prefix:DR
First Name:MAYURI
Middle Name:
Last Name:MORKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 N ROY AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60164-1213
Mailing Address - Country:US
Mailing Address - Phone:708-409-9786
Mailing Address - Fax:
Practice Address - Street 1:625 BETHANY RD
Practice Address - Street 2:SUITE #3
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-4908
Practice Address - Country:US
Practice Address - Phone:815-758-5800
Practice Address - Fax:815-758-5144
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.126280208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics