Provider Demographics
NPI:1366974891
Name:NEPOKULCHYTSKA, ULYANA (MHS, PA-C)
Entity type:Individual
Prefix:
First Name:ULYANA
Middle Name:
Last Name:NEPOKULCHYTSKA
Suffix:
Gender:F
Credentials:MHS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4N213 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:BENSENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60106-2701
Mailing Address - Country:US
Mailing Address - Phone:224-805-7532
Mailing Address - Fax:
Practice Address - Street 1:386 N YORK ST STE 100
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2365
Practice Address - Country:US
Practice Address - Phone:630-834-1557
Practice Address - Fax:630-834-3461
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.006137363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant