Active NPI
Deborah Murray
- Nurse Practitioner
- Evergreen Park, IL
National Provider Identifier
1376047480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 041277871
- Practice address
- 2955 W 95TH St
Evergreen Park, IL 60805-2409 - Phone
- (708) 422-0022
- Fax
- (708) 422-2266
- NPI assigned
- Mar 22, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 041277871 | IL | Primary |
Addresses
Primary practice location
2955 W 95TH St
Evergreen Park, IL 60805-2409
Mailing address
2955 W 95TH St
Evergreen Park, IL 60805-2409
Phone (708) 422-0022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041277871 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041277871 | IL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521676800000",
"number": "1376047480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2955 W 95TH ST",
"city": "EVERGREEN PARK",
"state": "IL",
"postal_code": "608052409",
"telephone_number": "708-422-0022",
"fax_number": "708-422-2266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2955 W 95TH ST",
"city": "EVERGREEN PARK",
"state": "IL",
"postal_code": "608052409",
"telephone_number": "708-422-0022",
"fax_number": "708-422-2266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MURRAY",
"first_name": "DEBORAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-22",
"last_updated": "2018-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "041277871",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "041277871",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evergreen Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.