Provider Demographics
NPI:1407671340
Name:MORRIS, STEPHANIE J
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:J
Last Name:MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3755 E MAIN ST STE 190
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2463
Mailing Address - Country:US
Mailing Address - Phone:630-549-6245
Mailing Address - Fax:
Practice Address - Street 1:3755 E MAIN ST STE 190
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2463
Practice Address - Country:US
Practice Address - Phone:630-549-6245
Practice Address - Fax:630-701-9500
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-16
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program