MEDICARE: THOMAS C MURPHY MD

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	2084P0800X	Psychiatry Physician	IL3639521	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0021600375	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1982611687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS C MURPHY MD

Provider Business Mailing Address
First Line	:	676 SAINT CLAIR
Second Line	:	SUITE 1735
City	:	CHICAGO
State	:	IL
Zip	:	60611
Country	:	US
Telephone Number	:	312-664-2753
Fax Number	:	312-642-2232

Provider Business Practice Location Address
First Line	:	676 SAINT CLAIR
Second Line	:	SUITE 1735
City	:	CHICAGO
State	:	IL
Zip	:	60611-2974
Country	:	US
Telephone Number	:	312-664-2753
Fax Number	:	312-642-2232

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	07/08/2007

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