MEDICARE: MS. PRISCILLA MURPHY KANG LCSW

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	1041C0700X	Clinical Social Worker	149013685	IL

General Provider Information

NPI Number	:	1447587936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PRISCILLA MURPHY KANG LCSW

Provider Business Mailing Address
First Line	:	1 N DEARBORN ST FL 10
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-4322
Country	:	US
Telephone Number	:	312-986-4158
Fax Number	:	312-986-4187

Provider Business Practice Location Address
First Line	:	1 N DEARBORN ST FL 10
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-4322
Country	:	US
Telephone Number	:	312-986-4158
Fax Number	:	312-986-4187

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

Provider Enumeration Date	:	11/04/2009
Last Update Date	:	12/14/2010

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