Provider Demographics
NPI:1255931952
Name:BULA, DAWID (PHARMD)
Entity type:Individual
Prefix:
First Name:DAWID
Middle Name:
Last Name:BULA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7090 S CICERO AVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60638
Mailing Address - Country:US
Mailing Address - Phone:708-496-0420
Mailing Address - Fax:
Practice Address - Street 1:7090 S CICERO AVE
Practice Address - Street 2:
Practice Address - City:BEDFORD PARK
Practice Address - State:IL
Practice Address - Zip Code:60638
Practice Address - Country:US
Practice Address - Phone:708-496-0420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.300984183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist