Active NPI
Michael Pulla, DPM
- Podiatrist
- Chicago, IL
National Provider Identifier
1568877819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 016.005658
- Practice address
- 1234 Wells
Chicago, IL 60612 - Phone
- (123) 456-7890
- NPI assigned
- Jun 25, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 135000848 | IL | |
| Podiatrist | 213E00000X | 016.005658 | IL | Primary |
Addresses
Primary practice location
1234 Wells
Chicago, IL 60612
Mailing address
1539 Farmside LN
Bolingbrook, IL 60490-4960
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016.005658 | IL | MD | Podiatrist |
| 135000848 | IL | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512086400000",
"number": "1568877819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1539 FARMSIDE LN",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604904960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1234 WELLS",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60612",
"telephone_number": "123-456-7890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PULLA",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-25",
"last_updated": "2017-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IL",
"license": "135000848",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IL",
"license": "016.005658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.