Provider Demographics
NPI:1386718310
Name:MORGAN, ROBERT I (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:I
Last Name:MORGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1938 CAMBRIDGE CT APT 4C
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-1490
Mailing Address - Country:US
Mailing Address - Phone:847-373-7416
Mailing Address - Fax:847-520-0500
Practice Address - Street 1:985 S BUFFALO GROVE RD
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-3702
Practice Address - Country:US
Practice Address - Phone:847-541-4878
Practice Address - Fax:847-520-0500
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212-769Medicare ID - Type UnspecifiedMEDICARE NON-PROVIDER NUM