Provider Demographics
NPI:1295035350
Name:ALLISON E. MURCHISON, M.D., S.C.
Entity Type:Organization
Organization Name:ALLISON E. MURCHISON, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:E
Authorized Official - Last Name:MURCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-257-1117
Mailing Address - Street 1:15900 W 127TH ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-2910
Mailing Address - Country:US
Mailing Address - Phone:630-257-1117
Mailing Address - Fax:630-257-1117
Practice Address - Street 1:15900 W 127TH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-2910
Practice Address - Country:US
Practice Address - Phone:630-257-1117
Practice Address - Fax:630-257-1117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-23
Last Update Date:2010-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036090860207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036090860Medicaid
IL202469Medicare PIN
ILG14094Medicare UPIN