Provider Demographics
NPI:1720658982
Name:EKSTROM, MORGAN NICOLE (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:NICOLE
Last Name:EKSTROM
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:NICOLE
Other - Last Name:STROM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:405 E ALTON ST
Mailing Address - Street 2:
Mailing Address - City:MARINE
Mailing Address - State:IL
Mailing Address - Zip Code:62061-1401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3402 ANDERSON HEALTHCARE DR
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-7712
Practice Address - Country:US
Practice Address - Phone:618-307-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist