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General NPI Number Information
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NPI Number | 1043319130
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Entity Type | Individual
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Provider Name | LULU HUSAIN M.D
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Gender | Female
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 836 W NELSON ST G87
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City | CHICAGO
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State | IL
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Zip | 60657-9238
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Country | US
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Telephone | 773-296-5486
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Fax |
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Provider Business Mailing Address
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Address Line | 5415 N SHERIDAN RD 4206
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City | CHICAGO
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State | IL
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Zip | 60640-1954
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Country | US
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Telephone | 773-561-8387
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036101351
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License Number State | IL
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