Individual
MRS. TAMMY SUE TULACRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT/LAT
Contact information
Practice address
1105 E HARRIS AVE, GREENVILLE, IL 62246-2221
(618) 664-4600
Mailing address
109 FOX HILL CT, EDWARDSVILLE, IL 62025-5736
(618) 655-9831
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
IL
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0332010
BCBS
IL
01
—
734380
HEALTHLINK PPO
IL
Enumeration date
10/05/2006
Last updated
09/11/2025
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