Provider Demographics
NPI:1659640126
Name:LULE, ANUELA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANUELA
Middle Name:
Last Name:LULE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 NORTH 76TH COURT
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-2525
Mailing Address - Country:US
Mailing Address - Phone:708-296-0324
Mailing Address - Fax:
Practice Address - Street 1:2409 N 76TH CT
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-2543
Practice Address - Country:US
Practice Address - Phone:708-296-0324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.295283183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist