Individual
THERESA PULICKAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
344 E HUNTINGTON LN, ELMHURST, IL 60126-3625
(956) 358-4501
Mailing address
344 E HUNTINGTON LN, ELMHURST, IL 60126-3625
(956) 358-4501
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.011040
IL
152W00000X
Optometrist
8703T
TX
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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