MEDICARE: SUMIA GULL

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	183500000X	Pharmacist	051307501	IL

General Provider Information

NPI Number	:	1548135098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUMIA GULL

Provider Business Mailing Address
First Line	:	632 LAKEWOOD FARMS DR
Second Line	:
City	:	BOLINGBROOK
State	:	IL
Zip	:	60490-3164
Country	:	US
Telephone Number	:	630-890-1224
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 E LAKE COOK RD
Second Line	:
City	:	WHEELING
State	:	IL
Zip	:	60090-2239
Country	:	US
Telephone Number	:	847-215-5055
Fax Number	:

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

Provider Enumeration Date	:	10/06/2025
Last Update Date	:	10/06/2025

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Directions to “ SUMIA GULL ” Practice Location

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