Provider Demographics
NPI:1982611687
Name:MURPHY, THOMAS C (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:C
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 SAINT CLAIR
Mailing Address - Street 2:SUITE 1735
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:312-664-2753
Mailing Address - Fax:312-642-2232
Practice Address - Street 1:676 SAINT CLAIR
Practice Address - Street 2:SUITE 1735
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2974
Practice Address - Country:US
Practice Address - Phone:312-664-2753
Practice Address - Fax:312-642-2232
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILIL36395212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0021600375OtherBCBS
600010Medicare ID - Type Unspecified
D13751Medicare UPIN