Provider Demographics
NPI:1255062071
Name:JULIE NELSON-KUNA, PHD, LLC
Entity type:Organization
Organization Name:JULIE NELSON-KUNA, PHD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON-KUNA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:331-472-7313
Mailing Address - Street 1:800 W 5TH AVE STE 205K
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-3522
Mailing Address - Country:US
Mailing Address - Phone:331-472-7313
Mailing Address - Fax:
Practice Address - Street 1:800 W 5TH AVE STE 205K
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-3522
Practice Address - Country:US
Practice Address - Phone:331-472-7313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)