Organization
WH IL MEDICAL PLLC
Active
Other names
Walmart Health
Organization subpart
No
Provider details
NPI number
Authorized official
SOUJANYA PULLURU (OWNER)
(479) 277-2500
Entity
Organization
Contact information
Practice address
1715 N. KILPATRICK AVE., CHICAGO, IL 60639
(773) 687-6041
(773) 276-7564
Mailing address
702 SW 8TH ST # MS 0445, BENTONVILLE, AR 72716-0445
(479) 204-1258
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
208D00000X
General Practice Physician
Primary
—
—
231H00000X
Audiologist
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/21/2020
Last updated
01/29/2021
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