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NPI Code Detail

MEDICARE: ROSEMARY PULOKA LCPC

MEDICARE: ROSEMARY PULOKA LCPC
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
1101YP2500XProfessional Counselor180011837IL

General Provider Information

NPI Number : 1215406442
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSEMARY PULOKA LCPC
Provider Business Mailing Address
First Line : 4025 N SHERIDAN RD
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2010
Country : US
Telephone Number : 773-388-1600
Fax Number : 773-388-1602
Provider Business Practice Location Address
First Line : 3948 N SHERIDAN RD
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2935
Country : US
Telephone Number : 773-388-1600
Fax Number : 773-388-1602
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2018
Last Update Date : 11/16/2018

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Directions to “ ROSEMARY PULOKA LCPC” Practice Location

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