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1689114506
LIA NICOLE FULKS
CHICAGO, IL
NPI
1689114506
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Former Name
LIA NICOLE MACKEY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: IL 146.010857)
Enumeration Date
2017-02-24
Last Update Date
2017-02-24
Business Address
LIA NICOLE FULKS MA CCC-SLP
345 E SUPERIOR ST
CHICAGO, IL 60611-2654
Phone number: 312-238-1000
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Mailing Address
LIA NICOLE FULKS MA CCC-SLP
3644 N DAMEN AVE UNIT 1
CHICAGO, IL 60618-4946
Phone number: 586-855-1025
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