Organization
PHILIP K MCCULLOUGH MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP K MCCULLOUGH MD (PRESIDENT)
(312) 695-3680
Entity
Organization
Contact information
Practice address
201 E HURON ST, SUITE 11-100, CHICAGO, IL 60611-3197
(312) 695-3680
(312) 926-3709
Mailing address
201 E HURON ST, SUITE 11-100, CHICAGO, IL 60611-3197
(312) 695-3680
(312) 926-3709
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635513
BCBSIL
IL
Enumeration date
05/30/2007
Last updated
08/22/2020
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