Provider Demographics
NPI:1104999515
Name:MORRIS, PATRICK JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 S OLD RAND RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-3129
Mailing Address - Country:US
Mailing Address - Phone:847-721-2933
Mailing Address - Fax:206-984-3218
Practice Address - Street 1:72 SOUTH OLD RAND ROAD
Practice Address - Street 2:SUITE 2
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-2359
Practice Address - Country:US
Practice Address - Phone:847-721-2933
Practice Address - Fax:206-984-3218
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008482111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210053Medicare UPIN
ILK10950Medicare ID - Type Unspecified