Provider Demographics
NPI:1669438271
Name:MORRIS, CASEY M (MD)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:M
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E 22ND ST
Mailing Address - Street 2:WEST SUBURBAN OB GYN LTD
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148
Mailing Address - Country:US
Mailing Address - Phone:630-620-8061
Mailing Address - Fax:
Practice Address - Street 1:500 E 22ND ST
Practice Address - Street 2:WEST SUBURBAN OB GYN LTD
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148
Practice Address - Country:US
Practice Address - Phone:630-620-8061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-22
Last Update Date:2021-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47349207V00000X
IL036.118578207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology