Chelsey Shantelle Morris, RDH, PHDH
Individual provider Active NPI Dental Hygienist · Clinton, IL
NPI 1558068528 · NPPES record last updated Feb 10, 2023
Key facts
- NPI
- 1558068528
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 020012339 (IL)
- Practice address
- 5924 Revere Rd
Clinton, IL 61727-2914 - Phone
- (217) 935-3427
- Fax
- (217) 935-9820
- NPI assigned
- Feb 10, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020012339 | IL | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dewitt-Piatt Bi-County Health Department | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | |||
| Dental Hygienist | 124Q00000X | 020012339 | IL | Yes |
Addresses
Primary practice location
5924 Revere Rd
Clinton, IL 61727-2914
Mailing address
457 Tyrone Dr
Forsyth, IL 62535-1069
Phone (217) 935-3427
Other providers in Clinton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2023. 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.