Provider Demographics
NPI:1174107692
Name:MURAD, RITA MICHAEL
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:MICHAEL
Last Name:MURAD
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:RITA
Other - Middle Name:MICHAEL
Other - Last Name:MURAD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:9042 TRIPP AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1608
Mailing Address - Country:US
Mailing Address - Phone:847-644-6425
Mailing Address - Fax:
Practice Address - Street 1:9042 TRIPP AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1608
Practice Address - Country:US
Practice Address - Phone:847-644-6425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL169.016312174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist