Provider Demographics
NPI:1326119512
Name:MURPHY, JENNIFER J (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:J
Last Name:MURPHY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13550 S ROUTE 30
Mailing Address - Street 2:# B104
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-5685
Mailing Address - Country:US
Mailing Address - Phone:815-230-3776
Mailing Address - Fax:
Practice Address - Street 1:13550 S ROUTE 30
Practice Address - Street 2:# B104
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-5685
Practice Address - Country:US
Practice Address - Phone:815-230-3776
Practice Address - Fax:815-664-3307
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006796111N00000X
IL038.011502111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO154187OtherBLUE CROSS BLUE SHIELD
MO000031784Medicare ID - Type Unspecified