Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 036121377 | IL |
NPI | 1568443752 |
---|---|
Provider Name | Dr. Peter J Hulick |
First Address | Evanston, IL 60201-1777 |
Second Address | Evanston, IL 60201-1777 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 11/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H75308 | (02) |