Provider Demographics
NPI:1497445829
Name:MURRAY, TANIA SCHAFER (PT)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:SCHAFER
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TANIA
Other - Middle Name:RECTOR
Other - Last Name:SCHAFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:10518 NEBRASKA ST
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-2201
Mailing Address - Country:US
Mailing Address - Phone:508-259-1658
Mailing Address - Fax:
Practice Address - Street 1:2772 NORTHERN LIGHTS WAY
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-7503
Practice Address - Country:US
Practice Address - Phone:708-400-8063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070014246225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist