| NPI | 1942910005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOUJANYA PULLURU Owner 630-545-4046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2022-11-30 |
| Last Update Date | 2022-11-30 |