Provider Demographics
NPI:1801329743
Name:MURDOCH, LISAMARIE (NP)
Entity type:Individual
Prefix:
First Name:LISAMARIE
Middle Name:
Last Name:MURDOCH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LISAMARIE
Other - Middle Name:
Other - Last Name:SCHREIBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10745 165TH ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-8713
Mailing Address - Country:US
Mailing Address - Phone:708-799-8384
Mailing Address - Fax:708-799-1305
Practice Address - Street 1:10745 165TH ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-8713
Practice Address - Country:US
Practice Address - Phone:708-799-8384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209015607363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily