Provider Demographics
NPI:1356078562
Name:FERRIS-JOHNSTON, MORGAN ELYSE (PSYD, MS)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:ELYSE
Last Name:FERRIS-JOHNSTON
Suffix:
Gender:F
Credentials:PSYD, MS
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:ELYSE
Other - Last Name:FERRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2700 PATRIOT BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8021
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2700 PATRIOT BLVD STE 240
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8021
Practice Address - Country:US
Practice Address - Phone:847-729-5510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-07
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071011030103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist