Healthcare Provider Details

I. General information

NPI: 1578427332
Provider Name (Legal Business Name): DEEPTHI CULL MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 E WOODMEN RD
COLORADO SPRINGS CO
80923-2601
US

IV. Provider business mailing address

4225 LINCOLNSHIRE DR STE B
MOUNT VERNON IL
62864-2157
US

V. Phone/Fax

Practice location:
  • Phone: 618-318-8416
  • Fax:
Mailing address:
  • Phone: 618-318-8416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DEEPTHI CULL
Title or Position: PROVIDER
Credential: MD
Phone: 847-767-0137