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General NPI Number Information
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NPI Number | 1730102468
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Entity Type | Individual
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Provider Name | MARY MURRAY PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 12/06/2025
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Provider Practice Location Address
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Address Line | 3207 LAKE AVE
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City | WILMETTE
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State | IL
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Zip | 60091-1082
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Country | US
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Telephone | 847-873-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 201 E HURON ST FLOOR 5, SUITE 110
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City | CHICAGO
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State | IL
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Zip | 60611-3197
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085000331
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 1689434987
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License Number State | IL
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