Basic Information
| Provider Information | |||||||||
| NPI: | 1952432239 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GULINO | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | ANTHONY | ||||||||
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| Credential: | APN, RN, ONC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2111 OGDEN AVE | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605047597 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6309783800 | ||||||||
| FaxNumber: | 6308623085 | ||||||||
| Practice Location | |||||||||
| Address1: | 2111 OGDEN AVE | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605047597 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6309783800 | ||||||||
| FaxNumber: | 6308623085 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2007 | ||||||||
| LastUpdateDate: | 05/04/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WX0800X | 041316365 | IL | N | Nursing Service Providers | Registered Nurse | Orthopedic | 363LF0000X | 209013555 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.