Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MACKENZIE ANN LULLO, AS, BAS, PTA
ActiveMACKENZIE ANN LULLO, AS, BAS, PTA is a Pediatric Rehabilitation Medicine healthcare provider located in WAUCONDA, Illinois. NPI 1063145712 is currently active in the NPPES registry. Verify at CMS.
Pediatric Rehabilitation Medicine · WAUCONDA, IL
Registration Details
- NPI Number
- 1063145712
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 8, 2022 (4.1393578435422 yrs)
- Last Updated
- Jul 8, 2022
- License
-
160.009537 (IL)
Practice Information
- Address
-
23525 W MILTON RDWAUCONDA, IL, 600842619Browse IL providers · Browse ZIP 60084
- Phone
- 8474385400
- Primary Specialty
-
Pediatric Rehabilitation Medicine
2081P0010X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.