Healthcare Provider Details

I. General information

NPI: 1972964773
Provider Name (Legal Business Name): SHARON GROB MURPHY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. SHARON GROB

II. Dates (important events)

Enumeration Date: 03/08/2016
Last Update Date: 03/10/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 E LAKE ST
CHICAGO IL
60601-5959
US

IV. Provider business mailing address

70 E LAKE ST STE 1300
CHICAGO IL
60601-7458
US

V. Phone/Fax

Practice location:
  • Phone: 312-726-4011
  • Fax:
Mailing address:
  • Phone: 312-726-4011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number71.004209
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number71.004209
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: