DRS. McCullom P.C.

Periodontics · Chicago, IL

Organization Active NPI

NPI number 1972649200

Practice location

820 E 87TH St
Suite 201
Chicago, IL 60619-6253
Phone
(773) 488-3738
Fax
(773) 874-6575

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NPI record

NPI
1972649200
Entity type
Organization (Type 2)
Enumeration date
January 30, 2007
Last updated
September 11, 2025
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Periodontics Primary 1223P0300X — —
Oral and Maxillofacial Surgery (Dentist) 1223S0112X — —

Authorized official

Name
Dr. Yetta G McCullom, DDS
Title
VP and Cheif Finanical Officer
Phone
(773) 488-3738

About DRS. McCullom P.C.

DRS. McCullom P.C. is a healthcare organization registered in the NPI registry with the primary taxonomy Periodontics (code 1223P0300X). The practice location is 820 E 87TH St, Suite 201, Chicago, IL 60619-6253. The NPI number 1972649200 was assigned on January 30, 2007 and the record was last updated on September 11, 2025.

The authorized official for this organization is Dr. Yetta G McCullom, DDS, VP and Cheif Finanical Officer.

Frequently asked questions

What is the NPI number of DRS. McCullom P.C.?

The NPI number is 1972649200.

What is the phone number of DRS. McCullom P.C.?

The phone number listed for the practice location is (773) 488-3738.

Where is DRS. McCullom P.C. located?

820 E 87TH St, Suite 201, Chicago, IL 60619-6253.

What is the taxonomy code for DRS. McCullom P.C.?

The primary taxonomy code is 1223P0300X – Periodontics; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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