Provider Demographics
NPI:1548034952
Name:WEISE, MORGAN (MS, RD)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:WEISE
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5446 E LINCOLN TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:FITHIAN
Mailing Address - State:IL
Mailing Address - Zip Code:61844-5173
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-7499
Practice Address - Country:US
Practice Address - Phone:630-527-5206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered