=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528566817
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NATALIE MURPHY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2018
-----------------------------------------------------
Last Update Date | 03/08/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 W ADAMS ST STE 411
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60606-5108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-894-2166
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 111 W WASHINGTON ST STE 917
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60602-2760
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 312-961-6564
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | NATALIE MURPHY
-----------------------------------------------------
Credential | LCPC
-----------------------------------------------------
Telephone | 312-961-6564
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 180010648
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------