Provider Demographics
NPI:1730460007
Name:GULA, MYRYL (PHARMD)
Entity Type:Individual
Prefix:
First Name:MYRYL
Middle Name:
Last Name:GULA
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 1:9800 IRVING PARK RD
Mailing Address - Street 2:
Mailing Address - City:SCHILLER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60176-1448
Mailing Address - Country:US
Mailing Address - Phone:847-233-0307
Mailing Address - Fax:
Practice Address - Street 1:9800 IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:SCHILLER PARK
Practice Address - State:IL
Practice Address - Zip Code:60176-1448
Practice Address - Country:US
Practice Address - Phone:847-233-0307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051289089183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist