Healthcare Provider Details

I. General information

NPI: 1154423382
Provider Name (Legal Business Name): JULIA M HULCHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 02/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 FAIR OAKS AVE. MEDICAL CONSULTING
OAK PARK IL
60302-1337
US

IV. Provider business mailing address

1025 FAIR OAKS AVE. MEDICAL CONSULTING
OAK PARK IL
60302-1337
US

V. Phone/Fax

Practice location:
  • Phone: 708-524-4295
  • Fax: 708-524-4617
Mailing address:
  • Phone: 708-524-4295
  • Fax: 708-524-4617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036072232
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: