Provider Demographics
NPI:1972051894
Name:EICHINGER-MURPHY, KAITLYN (PSYD)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:EICHINGER-MURPHY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:
Other - Last Name:EICHINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1786 MOON LAKE BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1067
Mailing Address - Country:US
Mailing Address - Phone:847-755-8536
Mailing Address - Fax:
Practice Address - Street 1:1786 MOON LAKE BLVD STE 208
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1067
Practice Address - Country:US
Practice Address - Phone:847-755-8536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071010388103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1473276Medicaid