VICTORIA TULLOCK (NPI# 1003346628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003346628 |
| Entity Type | Individual |
| Full Name | VICTORIA TULLOCK |
| Credential | MSW |
| Practice Address |
631 South First St. Dekalb IL 60115 |
| Mailing Address |
631 S 1st St Dekalb IL 60115-4117 |
| Practice Telephone | (815) 756-8501 |
| Mailing Telephone | 8157568501 |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2017-06-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 474579189001 | 05 |
| Street Address |
631 SOUTH FIRST ST. |
| City | DEKALB |
| State | IL |
| Zip Code | 60115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372179 | Megan Erhart | Counselor | 304 N. 6th Street, Dekalb, IL 60115 | 2020-09-28 |
| 1689141616 | Stephanie Klewin | Psychologist | 631 S 1st Street, Dekalb, IL 60115 | 2018-10-29 |
| 1164902219 | Kimberly Ann Hart | Counselor | 290 N. Annie Glidden Drive, Gh 416, Niu, Dekalb, IL 60115 | 2018-08-17 |
| 1497235824 | Cory David Michael Hayden | Specialist/Technologist | 175 Yordon Center (niu Athletic Training), Dekalb, IL 60115 | 2018-08-15 |
| 1154807808 | Michael John Borak | Pharmacist | 975 S Annie Glidden Road, Schnucks Market Inc, Dekalb, IL 60115 | 2018-07-16 |
| 1184125841 | Candace Schroeffel | Student in an Organized Health Care Education/Training Program | 520 Garden Rd, Dekalb, IL 60115 | 2018-02-27 |
| 1033627583 | Hannah M Studebaker | Massage Therapist | 3266 Sycamore Road, Dekalb, IL 60115 | 2018-01-18 |
| 1649700238 | Jennifer Mangino | Behavioral Analyst | 138 Berkshire Dr, Dekalb, IL 60115 | 2017-06-15 |
| 1194263848 | Brianna Kraft | Specialist/Technologist | 900 Crane Dr, Dekalb, IL 60115 | 2017-02-02 |
| 1043767031 | Aarthi Raghavan | Dentist | 2061 Sycamore Road, Dekalb, IL 60115 | 2016-09-07 |
| Find all providers in zip 60115 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372179 | Megan Erhart | Counselor | 304 N. 6th Street, Dekalb, IL 60115 | 2020-09-28 |
| 1164902219 | Kimberly Ann Hart | Counselor | 290 N. Annie Glidden Drive, Gh 416, Niu, Dekalb, IL 60115 | 2018-08-17 |
| 1689109837 | Monique Shante Shaw | Counselor | 2487 Alpha Ct W, Dekalb, IL 60115-5827 | 2017-04-25 |
| 1972946028 | Michael William Elgersma | Counselor | 1500 E Lincoln Hwy Ste 1, Dekalb, IL 60115-3990 | 2013-04-09 |
| 1326391806 | Thomas Mark Kuchynka | Counselor | 1134 Gifford St, Dekalb, IL 60115-4465 | 2012-10-20 |
| 1538432521 | Mark Daniel Lindsey | Counselor | 1400 W Lincoln Hwy, Dekalb, IL 60115-2831 | 2012-02-22 |
| 1932336674 | Jessica Rojas | Counselor | 221 W Lincoln Hwy, Dekalb, IL 60115-3688 | 2009-06-21 |
| 1114126018 | Karyanna Salentine | Counselor | 431 Russell Rd Apt 1, Dekalb, IL 60115-2290 | 2007-07-12 |
| 1255497491 | Sue E. Ouellette | Counselor | 400 E Hillcrest Dr, Suite 100a, Dekalb, IL 60115-2480 | 2006-12-30 |
| 1750354445 | Susan L Roberts | Counselor | 151 W Lincoln Hwy, Suite C, Dekalb, IL 60115-3680 | 2006-02-11 |
| Find all providers in DEKALB | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.