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Contact Information

MICHAEL A CERULLO, MD
2160 S 1ST AVE
MAYWOOD, IL60153-3328
 Phone: 708-216-9000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for MICHAEL A CERULLO · (Male)

NPI # 1649345026
Status Active
Credentials MD
Entity Individual
Enumeration date 11/21/2006
Last updated 11/14/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IL License # 036171397
  • OH License # 35086733
  • WA License # MD61590777
  • Other 0074946 OHIO DEPARTMENT MENTAL HEALTH (ODMH)
  • OH Other 01-0693 CARF CERTIFICATION
  • OH Other H297803 MEDICARE INDIVIDUAL PTAN
  • OH Other P00356887 MEDICARE RAILROAD
  • OH Other 0074861 OHIO DEPARTMENT ALCOHOL DRUG SERVICES (ODADAS)
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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