Provider Demographics
NPI:1770615320
Name:MORGAN, CATHERINE MARIE (PT)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:MARIE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 N KENILWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1317
Mailing Address - Country:US
Mailing Address - Phone:312-810-6050
Mailing Address - Fax:
Practice Address - Street 1:1027 N KENILWORTH AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1317
Practice Address - Country:US
Practice Address - Phone:312-810-6050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1634596OtherBLUE SHEILD PROVIDER