Provider Demographics
NPI:1366933848
Name:MURDOCK, CRYSTAL ROCHELLE (MA)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ROCHELLE
Last Name:MURDOCK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E 32ND ST APT 1008
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4915
Mailing Address - Country:US
Mailing Address - Phone:224-565-1161
Mailing Address - Fax:
Practice Address - Street 1:5642 W DIVERSEY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-1353
Practice Address - Country:US
Practice Address - Phone:708-465-1293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor