Provider Demographics
NPI:1477804565
Name:STEVEN F GULLA DC INC
Entity Type:Organization
Organization Name:STEVEN F GULLA DC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:GULLA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-255-0606
Mailing Address - Street 1:521 W CENTRAL RD
Mailing Address - Street 2:STE 2
Mailing Address - City:MT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-6514
Mailing Address - Country:US
Mailing Address - Phone:847-255-0606
Mailing Address - Fax:
Practice Address - Street 1:521 W CENTRAL RD
Practice Address - Street 2:STE 2
Practice Address - City:MT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-6514
Practice Address - Country:US
Practice Address - Phone:847-255-0606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038005808111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty