Individual
LAURA E KUKULSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4101 1ST AVE, LYONS, IL 60534-1028
(708) 447-6851
Mailing address
12811 S CEDAR LN, PALOS HEIGHTS, IL 60463-1916
(708) 528-0988
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.018412
IL
Other
Enumeration date
10/25/2018
Last updated
10/25/2018
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