Brian Peter Mcculloch
Gynecologist - Maternal & Fetal Medicine
1875 Dempster St Suite 325
Park Ridge
, Illinois 60068-1186
Brian Peter Mcculloch
Gynecologist - Maternal & Fetal Medicine
1875 Dempster St Suite 325
Park Ridge
, Illinois 60068-1186
(847) 723-8610
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About
Features
Specialties
- Gynecologist - Maternal & Fetal Medicine
Languages spoken
- English
Location
First Address
- Brian Peter Mcculloch
- 1875 Dempster St Suite 325
- Park Ridge, IL
- Zip : 60068-1186
- Phone : (847) 723-8610
Second Address
- Brian Peter Mcculloch
- 1875 Dempster St Suite 325
- Park Ridge, IL
- Zip : 60068-1186
- Phone : (847) 723-8610
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 036076949 | IL |
National Provider Identifier
| NPI | 1013943117 |
|---|---|
| Provider Name | Brian Peter Mcculloch |
| First Address | Park Ridge, IL 60068-1186 |
| Second Address | Park Ridge, IL 60068-1186 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/06/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036076949 | ILLINOIS STATE LICENSE NU (01) | IL |
| 36-4024817 | TAX ID (01) | IL |
| D16641 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.