Individual
KUNJUMOL PULLATHRA VELAYUDHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
3650 W 95TH ST, EVERGREEN PARK, IL 60805-2108
(708) 422-7715
(708) 422-7816
Mailing address
3650 W 95TH ST, EVERGREEN PARK, IL 60805-2108
(708) 422-7715
(708) 422-7816
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209006239
IL
Other
Enumeration date
10/03/2007
Last updated
02/25/2009
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