Wayne Mccullough

NPI 1033284179 · on the registry since 2006 · sole proprietor

Practice

Address: 21813 Cappel Ln
Frankfort, IL 60423
Phone: (978) 549-6818
Fax: (847) 674-0892
Organisation at this address: Prairie Podiatry Inc.
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy: 213E00000X
213E00000X
Also registered as: 213EP1101X
213ES0131X
213ES0000X
Licence states on file: MA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2015-09-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois