Provider Demographics
NPI:1710002191
Name:MORRISON, CHRISTINE DOYLE (MS, OTRL)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:DOYLE
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MS, OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 N BRAINARD AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60526-5520
Mailing Address - Country:US
Mailing Address - Phone:708-203-0569
Mailing Address - Fax:
Practice Address - Street 1:531 N BRAINARD AVE
Practice Address - Street 2:
Practice Address - City:LA GRANGE PARK
Practice Address - State:IL
Practice Address - Zip Code:60526-5520
Practice Address - Country:US
Practice Address - Phone:708-203-0569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1634773OtherBLUE CROSS BLUE SHIELD