Organization
CHICAGO SPORT AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUNIL SIMON PULLUKAT D.C (CHIROPRACTOR/ CEO)
(773) 852-8423
Entity
Organization
Contact information
Practice address
1200 OLD SKOKIE VALLEY RD, HIGHLAND PARK, IL 60035-3036
(773) 852-8423
Mailing address
5306 N RUTHERFORD AVE, CHICAGO, IL 60656-2131
(773) 852-8423
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038012256
IL
Other
Enumeration date
06/16/2014
Last updated
06/16/2014
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