# DRLULLABY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598433898
- **Authorized official:** LISA MEDALIE PSYD (CEO)
- **Authorized official phone:** (224) 572-8470

## Contact information

- **Practice address:** 400 W ONTARIO STREET, \#512, CHICAGO, IL 60654
- **Practice address phone:** (224) 572-8470
- **Mailing address:** 1440 W TAYLOR ST \# 556, CHICAGO, IL 60607-4623
- **Mailing address phone:** (619) 997-5759

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | NULL | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/01/2021
- **Last updated:** 03/27/2023