Provider Demographics
NPI:1457072670
Name:VULICH, NICHOLAS ANTHONY (ATS)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:ANTHONY
Last Name:VULICH
Suffix:
Gender:M
Credentials:ATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 JACKSON DR
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-1137
Mailing Address - Country:US
Mailing Address - Phone:630-479-1197
Mailing Address - Fax:
Practice Address - Street 1:2616 JACKSON DR
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-1137
Practice Address - Country:US
Practice Address - Phone:630-479-1197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program