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NPI Code Detail

MEDICARE: GREGORY HURULA

MEDICARE: GREGORY HURULA
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
1183500000XPharmacist051305635IL

General Provider Information

NPI Number : 1275364143
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY HURULA
Provider Business Mailing Address
First Line : 3910 W OGDEN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60623-2470
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3910 W OGDEN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60623-2470
Country : US
Telephone Number : 872-588-3250
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2024
Last Update Date : 08/12/2024

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Directions to “ GREGORY HURULA ” Practice Location

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