Provider Demographics
NPI:1598145799
Name:MORALES, ALLISON (OD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 W 75TH ST
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-9441
Mailing Address - Country:US
Mailing Address - Phone:630-225-7020
Mailing Address - Fax:
Practice Address - Street 1:2555 W 75TH ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-9441
Practice Address - Country:US
Practice Address - Phone:630-225-7020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.010879152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL8825444OtherMULTIPLAN
IL1636706OtherBCBS
IL0757500001Medicare NSC
IL1636706OtherBCBS