DR. Cornell Mccullom, D.D.S., M.D. is an oral and maxillofacial surgery dentist in Chicago, IL. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. Cornell Mccullom, D.D.S., M.D. NPI is 1619124807. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
820 E 87TH ST
STE. 201
CHICAGO, IL
ZIP 60619-253
Phone: (773) 488-3738
Fax: (773) 874-6575
The NPI 1619124807 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).
The enumeration date for this NPI number is 8/19/2008 and was last updated on 8/19/2008.