MEDICARE: AMBER LULLO CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	209034650	IL

General Provider Information

NPI Number	:	1013853928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER LULLO CNM

Provider Business Mailing Address
First Line	:	PO BOX 340
Second Line	:
City	:	AROMA PARK
State	:	IL
Zip	:	60910-0340
Country	:	US
Telephone Number	:	815-295-2782
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 BIESTERFIELD RD STE 105
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3393
Country	:	US
Telephone Number	:	847-228-9898
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2026
Last Update Date	:	04/24/2026

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