Healthcare Provider Details

I. General information

NPI: 1679496111
Provider Name (Legal Business Name): LAUREN MARIE MURRAY ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13011 S 104TH AVE STE 100
PALOS PARK IL
60464-1508
US

IV. Provider business mailing address

13011 S 104TH AVE
PALOS PARK IL
60464-1506
US

V. Phone/Fax

Practice location:
  • Phone: 708-274-3278
  • Fax:
Mailing address:
  • Phone: 708-274-3278
  • Fax: 708-274-3299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number209036196
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: