Individual
DR. JENNA JANIGA LULLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
150 HARVESTER DR STE 300, BURR RIDGE, IL 60527-5965
(773) 702-1150
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036158809
IL
207N00000X
Dermatology Physician
MD473582
PA
207ND0900X
Dermatopathology Physician
036158809
IL
Other
Enumeration date
05/13/2016
Last updated
10/10/2023
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