Provider Demographics
NPI:1518120732
Name:GULLEY, PAULETTE Y (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:PAULETTE
Middle Name:Y
Last Name:GULLEY
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1148 E 72ND ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-1335
Mailing Address - Country:US
Mailing Address - Phone:773-667-7700
Mailing Address - Fax:773-667-7700
Practice Address - Street 1:1148 E 72ND ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-1335
Practice Address - Country:US
Practice Address - Phone:773-667-7700
Practice Address - Fax:773-667-7700
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
IL146.005681235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist