Individual
BISSY KUMPUCKAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2213 HAMILTON LN, DARIEN, IL 60561-4346
(630) 689-6553
Mailing address
1333 BUTTERFIELD RD, STE 130, DOWNERS GROVE, IL 60515-5641
(630) 371-0133
(630) 371-0138
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209013257
IL
Other
Enumeration date
11/05/2015
Last updated
01/05/2016
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