Healthcare Provider Details

I. General information

NPI: 1598103020
Provider Name (Legal Business Name): KAREN HAYDEE HURULA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 04/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 THORNHILL DR
CAROL STREAM IL
60188-2706
US

IV. Provider business mailing address

650 E BUTTERFIELD RD # 403
LOMBARD IL
60148-5604
US

V. Phone/Fax

Practice location:
  • Phone: 630-752-9768
  • Fax:
Mailing address:
  • Phone: 630-344-3634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2013012277
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: