Tullia LLC

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

Legal business name

TULLIA LLC

Practice address

2455 Vicki LN
Northbrook, IL 60062-6923

Phone

(312) 351-0988

NPI assigned

Apr 8, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ketki ModiNPI 1477502326

Title

Physician

Phone

(312) 351-0988

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ketki Modi, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Chicago, IL
  • NPI 1477502326
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1487407789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 VICKI LN",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600626923",
            "telephone_number": "312-351-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 VICKI LN",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600626923",
            "telephone_number": "312-351-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULLIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "MODI",
        "authorized_official_first_name": "KETKI",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "312-351-0988",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• True Mind and Body LLC
• Kailei Trykowski
• Nikki Tsolakidis
• Jordan Tsoulos, BCBA
• Jody Tucker, LMT, CLT-LANA
• Crystal Turner
• Dana Michelle Turner, LCSW
• Sue Beth Turner, MS CCC SLP
• Serge G Tyler, MD
• Hailee M Tyner

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.