Healthcare Provider Details

I. General information

NPI: 1649039785
Provider Name (Legal Business Name): JESSICA CUSHING-MURRAY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 08/24/2024
Certification Date: 08/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 N BARRINGTON RD BLDG 1
HOFFMAN ESTATES IL
60169-1099
US

IV. Provider business mailing address

1555 N BARRINGTON RD BLDG 1
HOFFMAN ESTATES IL
60169-1099
US

V. Phone/Fax

Practice location:
  • Phone: 224-299-6939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number125084705
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: