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Wayne M Mccullough
Sports Medicine Podiatrist in Frankfort, Illinois
NPI 1033284179

Wayne M Mccullough is a Sports Medicine Podiatrist based in Frankfort, IL and is specialized in Sports Medicine. Wayne M Mccullough practices in Frankfort, IL. The NPI Number for Wayne M Mccullough is 1033284179 and holds a License No. 1939 (Illinois).

The current practice location address for Wayne M Mccullough is 21813 Cappel Ln, Frankfort, IL and can be reached out via phone at 978-549-6818 and via fax at 847-674-0892.

Location: 21813 Cappel Ln, Frankfort, IL, 60423-2275
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033284179
Provider Name
Wayne M Mccullough
Credential
Provider Entity Type
Individual
Gender
Male
Address
21813 Cappel Ln, Frankfort, IL, 60423-2275
Phone Number
978-549-6818
Fax Number
847-674-0892
Provider Enumeration Date
11/22/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0363037 05 MA
institution
Provider Business Practice Location Address Details
Address
21813 Cappel Ln
City
Frankfort
State
Illinois
Zip
60423-2275
Phone Number
978-549-6818
Fax Number
847-674-0892
person
Provider Business Mailing Address Details
Address
21813 Cappel Ln
City
Frankfort
State
Illinois
Zip
60423-2275
Phone Number
978-549-6818
Fax Number
847-674-0892
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
-
Taxonomy
213E00000X
License No.
1939 (Massachusetts)
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
person
Provider's Taxonomy Details 2
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Primary Podiatric Medicine
Taxonomy
213EP1101X
License No.
1939 (Massachusetts)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Sports Medicine
Taxonomy
213ES0000X
License No.
1939 (Massachusetts)
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot Surgery
Taxonomy
213ES0131X
License No.
1939 (Massachusetts)
Definition
Definition to come...
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