Provider Demographics
NPI:1558398263
Name:MURRAY, GINA M (DO)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:M
Last Name:MURRAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3824 N FREMONT ST
Mailing Address - Street 2:#1 SOUTH
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-3049
Mailing Address - Country:US
Mailing Address - Phone:630-290-2375
Mailing Address - Fax:
Practice Address - Street 1:885 ROOSEVELT RD STE 100
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-6141
Practice Address - Country:US
Practice Address - Phone:630-384-6200
Practice Address - Fax:630-384-6229
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI48973-021207P00000X
IL036109477207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43528700Medicaid
WIP00306274OtherMEDICARE RAILROAD
I50418Medicare UPIN