Healthcare Provider Details

I. General information

NPI: 1174413462
Provider Name (Legal Business Name): ANNE CULLUM RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 E ERIE ST STE 2450
CHICAGO IL
60611-3926
US

IV. Provider business mailing address

950 W MONROE ST UNIT 517
CHICAGO IL
60607-2982
US

V. Phone/Fax

Practice location:
  • Phone: 312-694-6447
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number041442933
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: