Provider Demographics
NPI:1558034827
Name:MURPHY, THERESA EILEEN (MS)
Entity Type:Individual
Prefix:MISS
First Name:THERESA
Middle Name:EILEEN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8135 APACHE TRL
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-6532
Mailing Address - Country:US
Mailing Address - Phone:708-557-0213
Mailing Address - Fax:
Practice Address - Street 1:9834 S HAMLIN AVE
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-3363
Practice Address - Country:US
Practice Address - Phone:708-921-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-31
Last Update Date:2021-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.006534235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist