Organization
OSH-IL PHYSICIANS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRENCE MORTON MD (CMO)
(704) 607-4835
Entity
Organization
Contact information
Practice address
2420 STATE ST, EAST SAINT LOUIS, IL 62205-2321
(618) 318-8809
(618) 615-4205
Mailing address
PO BOX 746096, ATLANTA, GA 30374-6096
(773) 352-1515
(312) 929-0373
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
12/20/2016
Last updated
07/23/2025
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