NPI 1720779663
Kenya Fulton
Practice location
- Address
- 931 Central Ave, Matteson, IL 60443-1542
- Phone
- (833) 534-2639
- Mailing address
- 1041 Monterey CT, University Park, IL 60484-3236
Registered specialties
Private Vehicle
Primary
Registry record
- NPI
- 1720779663
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 19 May 2023
- Record last updated
- 19 May 2023
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.