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General NPI Number Information
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NPI Number | 1972124352
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Entity Type | Organization
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Legal Business Name | MINDBODYHEART PSYCHIATRY PLLC
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Dates
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Enumeration Date | 04/27/2020
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 132 W LAKE ST
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1020
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Country | US
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Telephone | 773-417-6213
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Fax |
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Provider Business Mailing Address
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Address Line | 945 TARAVAL ST # 1239
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City | SAN FRANCISCO
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State | CA
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Zip | 94116-2422
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Country | US
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Telephone | 773-552-9688
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND OWNER
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Name | MICHELLE MURPHY
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Credential | MD
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Telephone | 773-417-6213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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