Individual
KRISTOPHER ROGER FULTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 283-5500
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
036.151194
IL
Other
Enumeration date
06/24/2009
Last updated
10/30/2024
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