Individual
BRIAN SMITH MCCALLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9414 ROUTE 176, CRYSTAL LAKE, IL 60014
(800) 361-6880
Mailing address
15127 S 73RD AVE, SUITE G, ORLAND PARK, IL 60462-4398
(800) 361-6880
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.005657
IL
Other
Enumeration date
02/09/2012
Last updated
02/09/2012
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