Individual
SUJATA SHUKLA GUR
Active
Individual
SUJATA SHUKLA GUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209006824
IL
363LA2200X
Adult Health Nurse Practitioner
Primary
209006824
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL7391001
MEDICARE PTAN
IL
Enumeration date
11/23/2007
Last updated
02/09/2023
Update your record
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