Healthcare Provider Details

I. General information

NPI: 1174101869
Provider Name (Legal Business Name): CAITLYN MURDOCK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 N LAKE SHORE DR STE 824
CHICAGO IL
60611-8702
US

IV. Provider business mailing address

680 N LAKE SHORE DR STE 824
CHICAGO IL
60611-8702
US

V. Phone/Fax

Practice location:
  • Phone: 312-943-3300
  • Fax: 312-266-4591
Mailing address:
  • Phone: 312-943-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number036-176238
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: