Healthcare Provider Details

I. General information

NPI: 1659201838
Provider Name (Legal Business Name): KOLUMA HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 BAYBROOK LN
OAK BROOK IL
60523-1641
US

IV. Provider business mailing address

74 BAYBROOK LN
OAK BROOK IL
60523-1641
US

V. Phone/Fax

Practice location:
  • Phone: 708-337-0047
  • Fax:
Mailing address:
  • Phone: 708-337-0047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SULING LI
Title or Position: SOLE MEMBER
Credential: FNP
Phone: 708-337-0047