Kristopher Roger Fultz
Critical Care Medicine
4440 W 95th St Ste Aip
Oak Lawn
, Illinois 60453-2600
Kristopher Roger Fultz
Critical Care Medicine
4440 W 95th St Ste Aip
Oak Lawn
, Illinois 60453-2600
(708) 684-5094
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About
Features
Specialties
- Critical Care Medicine
Languages spoken
- English
Location
First Address
- Kristopher Roger Fultz
- 4440 W 95th St Ste Aip
- Oak Lawn, IL
- Zip : 60453-2600
- Phone : (708) 684-5094
Second Address
- Kristopher Roger Fultz
- 4440 W 95th St Ste Aip
- Oak Lawn, IL
- Zip : 60453-2600
- Phone : (708) 684-5094
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RC0200X | Critical Care Medicine | 036.151194 | IL |
National Provider Identifier
| NPI | 1083842439 |
|---|---|
| Provider Name | Kristopher Roger Fultz |
| First Address | Oak Lawn, IL 60453-2600 |
| Second Address | Oak Lawn, IL 60453-2600 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/06/2009 |
| Last Update Date | 15/10/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.