Willie Morris III
Individual provider Active NPI Driver · Sauk Village, IL
NPI 1003482761 · NPPES record last updated Jun 2, 2021
Key facts
- NPI
- 1003482761
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 22205 Peachtree Ave
Sauk Village, IL 60411 - Phone
- (708) 953-6010
- NPI assigned
- Jun 2, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
22205 Peachtree Ave
Sauk Village, IL 60411
Mailing address
22205 Peach Tree Ave
Sauk Village, IL 60411-5157
Phone (708) 954-6010
Other providers in Sauk Village, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.