MEDICARE: ANN FORDE MURRAY M.A. L.C.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	101YP2500X	Professional Counselor		IL

General Provider Information

NPI Number	:	1760661219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN FORDE MURRAY M.A. L.C.P.C.

Provider Business Mailing Address
First Line	:	5116 FOREST AVE
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-4658
Country	:	US
Telephone Number	:	630-217-0115
Fax Number	:

Provider Business Practice Location Address
First Line	:	5116 FOREST AVE
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-4658
Country	:	US
Telephone Number	:	630-217-0115
Fax Number	:

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

Provider Enumeration Date	:	11/01/2007
Last Update Date	:	11/01/2007

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