Individual
MR. MICHAEL FERNANDOPULLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
211 E DELAWARE PL, UNIT 602, CHICAGO, IL 60611-1031
(708) 663-4051
Mailing address
211 E DELAWARE PL, UNIT 602, CHICAGO, IL 60611-1031
(708) 663-4051
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/16/2015
Last updated
02/16/2015
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