Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 036-106805 | IL |
NPI | 1134219942 |
---|---|
Provider Name | Dr. Jeffrey James Kulik |
First Address | Warrenville, IL 60555-4025 |
Second Address | Elmhurst, IL 60126-2816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 21/06/2021 |