Provider Demographics
NPI:1396882429
Name:MURPHY, KRISTA LENN (MS, OTRL)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:LENN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MS, OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 MANDEL AVE
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-4126
Mailing Address - Country:US
Mailing Address - Phone:708-790-4834
Mailing Address - Fax:708-488-9411
Practice Address - Street 1:2130 MANDEL AVE
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-4126
Practice Address - Country:US
Practice Address - Phone:708-790-4834
Practice Address - Fax:708-488-9411
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056004383225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist