Provider Demographics
NPI:1861003436
Name:CULAFOVSKI, LIRIJE
Entity Type:Individual
Prefix:
First Name:LIRIJE
Middle Name:
Last Name:CULAFOVSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 PLAINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5341
Mailing Address - Country:US
Mailing Address - Phone:630-789-1797
Mailing Address - Fax:630-789-2463
Practice Address - Street 1:501 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-5341
Practice Address - Country:US
Practice Address - Phone:630-789-1797
Practice Address - Fax:630-789-2463
Is Sole Proprietor?:No
Enumeration Date:2020-08-16
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051300754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist