Provider Demographics
NPI:1891170866
Name:MURAKAMI, TIMOTHY (LSW)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:MURAKAMI
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 W ARDMORE AVE
Mailing Address - Street 2:#2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-3441
Mailing Address - Country:US
Mailing Address - Phone:773-499-9947
Mailing Address - Fax:
Practice Address - Street 1:334 N MENARD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60644-2157
Practice Address - Country:US
Practice Address - Phone:773-537-3387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-20
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical