Provider Demographics
NPI:1306620737
Name:MURPHY, GREGORY A (APRN)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:A
Last Name:MURPHY
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3224 RIDGE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-3191
Mailing Address - Country:US
Mailing Address - Phone:708-394-3296
Mailing Address - Fax:312-877-5015
Practice Address - Street 1:6700 W 95TH ST STE 320
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2388
Practice Address - Country:US
Practice Address - Phone:708-422-7758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209023810363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily