Provider Demographics
NPI:1194539940
Name:HULETT, KATIE (CO)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:HULETT
Suffix:
Gender:F
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:0S036 CHURCH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1203
Mailing Address - Country:US
Mailing Address - Phone:331-732-4378
Mailing Address - Fax:
Practice Address - Street 1:0S036 CHURCH ST STE 200
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1203
Practice Address - Country:US
Practice Address - Phone:331-732-4378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1900XEye and Vision Services ProvidersTechnician/TechnologistOrthoptist