Provider Demographics
NPI:1497270219
Name:MURPHY, KIMBERLY ANN (MS-CF-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MS-CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 RENKEN RD
Mailing Address - Street 2:
Mailing Address - City:DORSEY
Mailing Address - State:IL
Mailing Address - Zip Code:62021-1607
Mailing Address - Country:US
Mailing Address - Phone:618-660-9062
Mailing Address - Fax:618-377-9028
Practice Address - Street 1:5959 RENKEN RD
Practice Address - Street 2:
Practice Address - City:DORSEY
Practice Address - State:IL
Practice Address - Zip Code:62021-1607
Practice Address - Country:US
Practice Address - Phone:618-660-9062
Practice Address - Fax:618-377-9028
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.004434235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist