Healthcare Provider Details

I. General information

NPI: 1568303311
Provider Name (Legal Business Name): TROY JAMES MASKEL RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2026
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 LAKE CT
CATLIN IL
61817-9255
US

IV. Provider business mailing address

102 LAKE CT
CATLIN IL
61817-9255
US

V. Phone/Fax

Practice location:
  • Phone: 217-474-2859
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041445323
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: