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NPI Code Detail

MEDICARE: MS. MYRALEN MCMURTRY NP

MEDICARE: MS. MYRALEN MCMURTRY NP
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
1363LF0000XFamily Nurse Practitioner209-001960IL

General Provider Information

NPI Number : 1376578898
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MYRALEN MCMURTRY NP
Provider Business Mailing Address
First Line : 17535 CHESTNUT AVE
Second Line :
City : COUNTRY CLUB HILLS
State : IL
Zip : 60478-4809
Country : US
Telephone Number : 708-957-9308
Fax Number : 708-957-9308
Provider Business Practice Location Address
First Line : 9718 S HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60628-1007
Country : US
Telephone Number : 708-293-8132
Fax Number : 708-293-8110
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 03/25/2013

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