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NPI Code Detail

MEDICARE: JOSEPH THOMAS MASON MD

MEDICARE: JOSEPH THOMAS MASON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry Physician036-065073IL
22084P0800XPsychiatry Physician036065073IL

General Provider Information

NPI Number : 1396858296
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH THOMAS MASON MD
Provider Business Mailing Address
First Line : 1752 W ROSCOE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60657-1016
Country : US
Telephone Number : 773-296-3220
Fax Number :
Provider Business Practice Location Address
First Line : 938 W NELSON ST
Second Line : 3RD FLOOR
City : CHICAGO
State : IL
Zip : 60657-6704
Country : US
Telephone Number : 773-296-3220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2006
Last Update Date : 04/27/2021

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Directions to “ JOSEPH THOMAS MASON MD” Practice Location

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