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General NPI Number Information
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NPI Number | 1366113524
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Entity Type | Individual
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Provider Name | JENAE MURRY
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Gender | Female
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Dates
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Enumeration Date | 09/27/2021
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 4619 N RAVENSWOOD AVE STE 300
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City | CHICAGO
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State | IL
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Zip | 60640-4579
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Country | US
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Telephone | 773-697-7333
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Fax |
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Provider Business Mailing Address
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Address Line | 5406 MERLE HAY RD
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City | JOHNSTON
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State | IA
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Zip | 50131-1209
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 111016
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056.016190
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License Number State | IL
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