Provider Demographics
NPI:1366084105
Name:MURDOCK, MORGAN JO (RDN)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:JO
Last Name:MURDOCK
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 W HAWTHORNE PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-2907
Mailing Address - Country:US
Mailing Address - Phone:785-249-7652
Mailing Address - Fax:
Practice Address - Street 1:160 N WACKER DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-1633
Practice Address - Country:US
Practice Address - Phone:872-704-0628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered