Individual
CAYLA M HULTMARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3551 HIGHLAND AVE STE 200A, DOWNERS GROVE, IL 60515-2100
(844) 376-3876
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085-009610
LICENSE
IL
Enumeration date
08/12/2021
Last updated
08/10/2023
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