Provider Demographics
NPI:1891768859
Name:MORTON, STEVEN D (DO)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:D
Last Name:MORTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9515 HOLY CROSS LN STE 175
Mailing Address - Street 2:
Mailing Address - City:BREESE
Mailing Address - State:IL
Mailing Address - Zip Code:62230-3618
Mailing Address - Country:US
Mailing Address - Phone:618-526-8430
Mailing Address - Fax:618-526-7275
Practice Address - Street 1:9515 HOLY CROSS LN
Practice Address - Street 2:
Practice Address - City:BREESE
Practice Address - State:IL
Practice Address - Zip Code:62230-3618
Practice Address - Country:US
Practice Address - Phone:618-641-5803
Practice Address - Fax:618-607-5116
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036111970207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036111970Medicaid
IL1891768859Medicaid
K10343Medicare ID - Type Unspecified
6394100001Medicare NSC
IL1891768859Medicaid
ILIL3501005Medicare PIN
F66498Medicare UPIN
IL036111970Medicaid