MEDICARE: DR. BRIAN MURRAY P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	036-126661	IL
2	202K00000X	Phlebology Physician	036-126661	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	IL7858	OTHER	IL	PTAN

General Provider Information

NPI Number	:	1346488400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN MURRAY P.C.

Provider Business Mailing Address
First Line	:	5318 W DEVON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-4108
Country	:	US
Telephone Number	:	773-303-7711
Fax Number	:

Provider Business Practice Location Address
First Line	:	5318 W DEVON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-4108
Country	:	US
Telephone Number	:	773-303-7711
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2009
Last Update Date	:	09/30/2024

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Directions to “ DR. BRIAN MURRAY P.C.” Practice Location

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