# DR. DERYL WAYNE DRUM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1871668319
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 019021404 | IL | — |
| 1223P0221X | Pediatric Dentistry | 021-001565 | IL | Yes |
| 1223P0221X | Pediatric Dentistry | 021001565 | IL | — |

## Other

- **Enumeration date:** 11/21/2006
- **Last updated:** 08/29/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1001718 | — | IL |