Organization
TULLIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KETKI MODI (PHYSICIAN)
(312) 351-0988
Entity
Organization
Contact information
Practice address
2455 VICKI LN, NORTHBROOK, IL 60062-6923
(312) 351-0988
Mailing address
2455 VICKI LN, NORTHBROOK, IL 60062-6923
(312) 351-0988
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
—
—
Other
Enumeration date
04/08/2024
Last updated
04/08/2024
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