Healthcare Provider Details

I. General information

NPI: 1326119512
Provider Name (Legal Business Name): JENNIFER J MURPHY MRAVLE D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER J MURPHY MRAVLE D.C

II. Dates (important events)

Enumeration Date: 11/11/2006
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13550 S ROUTE 30 # B104
PLAINFIELD IL
60544-5685
US

IV. Provider business mailing address

13550 S ROUTE 30 STE 104B
PLAINFIELD IL
60544-5687
US

V. Phone/Fax

Practice location:
  • Phone: 815-230-3776
  • Fax: 815-664-3307
Mailing address:
  • Phone: 815-230-3776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.011502
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number006796
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier154187
Identifier TypeOTHER
Identifier StateMO
Identifier IssuerBLUE CROSS BLUE SHIELD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: