Provider Demographics
NPI:1861877300
Name:SANTILUKKA, PEARL H (OD)
Entity type:Individual
Prefix:DR
First Name:PEARL
Middle Name:H
Last Name:SANTILUKKA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:730 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-1914
Mailing Address - Country:US
Mailing Address - Phone:847-362-9900
Mailing Address - Fax:
Practice Address - Street 1:3100 W IL ROUTE 60
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-4267
Practice Address - Country:US
Practice Address - Phone:847-566-5137
Practice Address - Fax:847-566-5628
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010933152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist