Healthcare Provider Details

I. General information

NPI: 1023363868
Provider Name (Legal Business Name): CAITLIN A MURRAY PT,DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2012
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 WAUKEGAN RD
LAKE BLUFF IL
60044-1666
US

IV. Provider business mailing address

205 W WACKER DR SUITE 1020
CHICAGO IL
60606-1216
US

V. Phone/Fax

Practice location:
  • Phone: 847-735-8104
  • Fax: 847-735-8231
Mailing address:
  • Phone: 312-640-0329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070-019597
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: