Basic Information
| Provider Information | |||||||||
| NPI: | 1184931016 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.S., CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10603 OAK AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO RIDGE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604151929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7085671562 | ||||||||
| FaxNumber: | 7084231562 | ||||||||
| Practice Location | |||||||||
| Address1: | 11531 SWINFORD LN | ||||||||
| Address2: | |||||||||
| City: | MOKENA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604489274 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2192290322 | ||||||||
| FaxNumber: | 7084792112 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2010 | ||||||||
| LastUpdateDate: | 09/14/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 146.010339 | IL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.