Basic Information
| Provider Information | |||||||||
| NPI: | 1083699573 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURCHISON | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | EILEEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 OGDEN AVE | ||||||||
| Address2: | |||||||||
| City: | DOWNERS GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605152865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6309633937 | ||||||||
| FaxNumber: | 6309636802 | ||||||||
| Practice Location | |||||||||
| Address1: | 15900 W 127TH ST | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | LEMONT | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604397461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6302571117 | ||||||||
| FaxNumber: | 6302571117 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2005 | ||||||||
| LastUpdateDate: | 12/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 36090860 | IL | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 1632645 | 01 | IL | BLUE CROSS IDENTIFIER | OTHER | 36090860 | 05 | IL | MEDICAID |