Provider Demographics
NPI:1497802730
Name:JUSUFI, LULJETA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LULJETA
Middle Name:
Last Name:JUSUFI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3166 N LINCOLN AVE
Mailing Address - Street 2:SUITE #300
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3133
Mailing Address - Country:US
Mailing Address - Phone:773-755-4000
Mailing Address - Fax:773-755-4431
Practice Address - Street 1:3166 N LINCOLN AVE
Practice Address - Street 2:SUITE #300
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3133
Practice Address - Country:US
Practice Address - Phone:773-755-4000
Practice Address - Fax:773-755-4431
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice