Wallace T Kellum
Driver • Chicago, IL
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Wallace Kellum has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Wallace Kellum was a registered Driver practicing in Chicago, IL. Throughout an active medical career spanning 4 years, Wallace Kellum provided care at the practice location at 5949 S ABERDEEN ST until profile deactivation on 2026-02-07.
Practice Location & Contact Primary Location
5949 S Aberdeen St
Chicago, IL 606211429
Specialty Benchmarks & Practice Insights
Comparative analytics for Driver in Chicago, IL
Practicing in Chicago, IL (286 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 172A00000X
A person employed to operate a motor vehicle as a carrier of persons or property.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on February 07, 2026
NPI status registered as active in NPPES database
Registered at 5949 S ABERDEEN ST, CHICAGO, IL 606211429 (Tel: 7735569732)
Registered at 5949 S ABERDEEN ST, CHICAGO, IL 606211429 (Tel: 7735569732)
Recorded as WALLACE KELLUM
Driver (License #CG83801 in IL)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
5949 S Aberdeen St
Chicago, IL 606211429
Phone: 7735569732
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