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NPI Code Detail

MEDICARE: MORGAN JO MURDOCK RDN

MEDICARE: MORGAN JO MURDOCK RDN
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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1366084105
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN JO MURDOCK RDN
Provider Business Mailing Address
First Line : 525 W HAWTHORNE PL
Second Line :
City : CHICAGO
State : IL
Zip : 60657-2907
Country : US
Telephone Number : 785-249-7652
Fax Number :
Provider Business Practice Location Address
First Line : 160 N WACKER DR
Second Line :
City : CHICAGO
State : IL
Zip : 60606-1633
Country : US
Telephone Number : 872-704-0628
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2019
Last Update Date : 10/14/2019

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