Basic Information
| Provider Information | |||||||||
| NPI: | 1952821662 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SALADA | ||||||||
| FirstName: | CULLEN | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3800 W MADISON ST | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606242312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7738266600 | ||||||||
| FaxNumber: | 8124611057 | ||||||||
| Practice Location | |||||||||
| Address1: | 3800 W MADISON ST | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606242312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7738266600 | ||||||||
| FaxNumber: | 8124611057 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2017 | ||||||||
| LastUpdateDate: | 12/21/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 036152029 | IL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.