Healthcare Provider Details

I. General information

NPI: 1548125933
Provider Name (Legal Business Name): MCCULLOCH CHIROPRACTIC AND REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12337 RT. 59 UNIT 119
PLAINFIELD IL
60585
US

IV. Provider business mailing address

2215 PRESTON LAKES CT
PLAINFIELD IL
60586-6253
US

V. Phone/Fax

Practice location:
  • Phone: 412-965-2525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM MCCULLOCH
Title or Position: OWNER
Credential: DC
Phone: 412-965-2525