Healthcare Provider Details

I. General information

NPI: 1043480874
Provider Name (Legal Business Name): JEANELLE Y MURPHY D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JEANELLE Y GILBERT D.O.

II. Dates (important events)

Enumeration Date: 03/07/2008
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 RICHMOND AVE E STE 2
MATTOON IL
61938-4652
US

IV. Provider business mailing address

PO BOX 372
MATTOON IL
61938-0372
US

V. Phone/Fax

Practice location:
  • Phone: 217-234-7000
  • Fax: 217-238-2584
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036123277
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: