Mario Gerard Massullo D.O.

  • 1043228158 NPI Number
  • |
  • Actived: 12 years ago
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According to our database, NPI number for Mario Gerard Massullo D.O. is 1043228158 and actived since Friday, August 4 2006. Mario Gerard Massullo D.O. is an individual provider specializes in Internal Medicine, primary practice location is 1710 W. Court St., Kankakee, IL 60901. You can also contact Mario Gerard Massullo D.O. via telephone number is (815) 936-3200. Provider NPI information was last updated on 07/08/2019.

Overview of Mario Gerard Massullo D.O.

  • NPI number: 1043228158
  • Provider type: Individual
  • Specialty: Internal Medicine
  • Gender: Male
  • Active since: 08/04/2006
  • Last updated: 07/08/2019

Provider Mailing Address

  • Address: 1710 W Court St
    Kankakee, IL 60901
  • Phone: 815-936-3200
  • Fax:

Provider Practice Location

  • Address: 1710 W. Court St.
    Kankakee, IL 60901
  • Phone: 815-936-3200
  • Fax: 815-936-3203

Scope of Practice

  • Taxonomy Code: 207R00000X
  • Specialty: Internal Medicine
  • License Number: 036082059
  • License State: IL
  • Switch: No

Legacy Identifiers

  • Provider Identifier: 036082059
  • Identifier Type: Medicare Oscar/Certification
  • Identifier State: IL
  • Issuer:

Question & Answers

What is the npi number?

  • Q: What is the npi number for Mario Gerard Massullo D.O.?
  • A: The npi number for Mario Gerard Massullo D.O. is 1043228158.
  • Q: What are Mario Gerard Massullo D.O.'s specialties?
  • A: Mario Gerard Massullo D.O.'s specialties are Internal Medicine and different specialities.
  • Q: What is the medical license for Mario Gerard Massullo D.O.?
  • A: The medical license number for Mario Gerard Massullo D.O. is 036082059 and issued in IL in USA.
  • Q: Where is Mario Gerard Massullo D.O. practice location?
  • A: Mario Gerard Massullo D.O. is practicing at 1710 W. Court St., Kankakee, IL 60901.
  • Q: How to contact Mario Gerard Massullo D.O.?
  • A: You can contact Mario Gerard Massullo D.O. via 815-936-3200.

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