Provider Demographics
NPI:1043319130
Name:HUSAIN, LULU (MD)
Entity type:Individual
Prefix:DR
First Name:LULU
Middle Name:
Last Name:HUSAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5415 N SHERIDAN RD
Mailing Address - Street 2:4206
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-1954
Mailing Address - Country:US
Mailing Address - Phone:773-561-8387
Mailing Address - Fax:
Practice Address - Street 1:836 W NELSON ST
Practice Address - Street 2:G87
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-9238
Practice Address - Country:US
Practice Address - Phone:773-296-5486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036101351207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine