Provider Demographics
NPI:1538957881
Name:MORRISSEY, BENJAMIN JAMES
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:JAMES
Last Name:MORRISSEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 N MAIN ST STE 103
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5101
Mailing Address - Country:US
Mailing Address - Phone:312-401-0990
Mailing Address - Fax:
Practice Address - Street 1:411 N MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5101
Practice Address - Country:US
Practice Address - Phone:312-401-0990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health