Provider Demographics
NPI:1700452596
Name:PULLURU, SHILPA
Entity Type:Individual
Prefix:
First Name:SHILPA
Middle Name:
Last Name:PULLURU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHILPA
Other - Middle Name:
Other - Last Name:CHALIMEDA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3107 SEILER CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-4424
Mailing Address - Country:US
Mailing Address - Phone:847-744-0204
Mailing Address - Fax:
Practice Address - Street 1:645 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60644-5059
Practice Address - Country:US
Practice Address - Phone:847-744-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program