Provider Demographics
NPI:1023426319
Name:MURPHY, REBECCA
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5460 WINNERS CIR
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:IL
Mailing Address - Zip Code:61011-9694
Mailing Address - Country:US
Mailing Address - Phone:815-323-2444
Mailing Address - Fax:
Practice Address - Street 1:5460 WINNERS CIR
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:IL
Practice Address - Zip Code:61011-9694
Practice Address - Country:US
Practice Address - Phone:815-323-2444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist