Provider Demographics
NPI:1649391186
Name:MURRAY, PATRICE ANNE (DNP)
Entity Type:Individual
Prefix:DR
First Name:PATRICE
Middle Name:ANNE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 W GROVE ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1759
Mailing Address - Country:US
Mailing Address - Phone:847-767-6894
Mailing Address - Fax:
Practice Address - Street 1:908 W GROVE ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1759
Practice Address - Country:US
Practice Address - Phone:847-767-6894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041206411163WP0000X
IL209-001618363L00000X
NC5009136363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WP0000XNursing Service ProvidersRegistered NursePain Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209001618Medicaid
IL209001618Medicaid
NC1649391186Medicaid