OrganizationActive
Drs. Mccullom P.C.
NPI 1972649200 · Periodontics · Chicago, IL
Provider details
- NPI number
- 1972649200
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Organization subpart
- No
- Authorized official
- Yetta Mccullom, Vp and Cheif Finanical Officer(773) 488-3738
Specialties & taxonomies
Dental Providers
- Oral and Maxillofacial Surgery (Dentist)1223S0112X
Dental Providers
Practice location
820 E 87th St
Suite 201
Chicago, IL 60619-6253
Phone: (773) 488-3738
Fax: (773) 874-6575
Approximate (ZIP-level) locationGet directions
Mailing address
820 E 87th St
Chicago, IL 60619-6253
Registry dates
- Enumerated
- 2007-01-30
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.