Provider Demographics
NPI:1598009425
Name:MURPHY, PAMELA (PSYD)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:QUINTANILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14953 S VAN DYKE RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-5804
Mailing Address - Country:US
Mailing Address - Phone:815-609-1544
Mailing Address - Fax:815-609-1670
Practice Address - Street 1:14953 S VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-5804
Practice Address - Country:US
Practice Address - Phone:815-609-1544
Practice Address - Fax:815-609-1670
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008153103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical