Provider Demographics
NPI:1750907044
Name:MCCALL, KIRK LYDELL II (MD)
Entity type:Individual
Prefix:
First Name:KIRK
Middle Name:LYDELL
Last Name:MCCALL
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 S MICHIGAN AVE
Mailing Address - Street 2:STE 172
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605
Mailing Address - Country:US
Mailing Address - Phone:312-999-0392
Mailing Address - Fax:312-900-8344
Practice Address - Street 1:4711 GOLF RD
Practice Address - Street 2:STE 1200
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1200
Practice Address - Country:US
Practice Address - Phone:312-999-0392
Practice Address - Fax:312-900-8344
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-22
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.0760952084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry