Provider Demographics
NPI:1124174859
Name:STEPHEN R MORSE MD SC
Entity type:Organization
Organization Name:STEPHEN R MORSE MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-945-6430
Mailing Address - Street 1:125 ARROWWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1038
Mailing Address - Country:US
Mailing Address - Phone:847-272-8252
Mailing Address - Fax:
Practice Address - Street 1:400 LAKE COOK RD
Practice Address - Street 2:SUITE 221
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-5607
Practice Address - Country:US
Practice Address - Phone:847-945-6430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0004900631OtherBLUE CROSS BLUE SHIELD
ILD86677Medicare UPIN
IL235300Medicare ID - Type UnspecifiedMEDICARE