Provider Demographics
NPI:1043398738
Name:MURPHY, LINDA HENSLEIGH JEAN (MPH RD LD)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:HENSLEIGH JEAN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MPH RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190
Mailing Address - Country:US
Mailing Address - Phone:630-933-6301
Mailing Address - Fax:630-752-0952
Practice Address - Street 1:25 WINFIELD RD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190
Practice Address - Country:US
Practice Address - Phone:630-933-6301
Practice Address - Fax:630-752-0952
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL206895Medicare ID - Type UnspecifiedCMS CLINIC GROUP
ILK0081Medicare ID - Type UnspecifiedCMS MEMBER