Healthcare Provider Details

I. General information

NPI: 1356207492
Provider Name (Legal Business Name): TULLY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 W BELMONT AVE
CHICAGO IL
60657-8496
US

IV. Provider business mailing address

1221 HULL TER APT 2E
EVANSTON IL
60202-3256
US

V. Phone/Fax

Practice location:
  • Phone: 224-260-5660
  • Fax:
Mailing address:
  • Phone: 773-875-2081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: SEANNA MAUREEN TULLY
Title or Position: OWNER
Credential: DACM
Phone: 773-875-2081