Individual
DR. CORNELL MCCULLOM III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
820 E 87TH ST, STE. 201, CHICAGO, IL 60619-6253
(773) 488-3738
(773) 874-6575
Mailing address
820 E 87TH ST, STE. 201, CHICAGO, IL 60619-6253
(773) 488-3738
(773) 874-6575
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021001488
IL
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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