Healthcare Provider Details

I. General information

NPI: 1619503810
Provider Name (Legal Business Name): LINDA MASKERI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 03/19/2020
Certification Date: 03/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 N YORK ST
ELMHURST IL
60126-1903
US

IV. Provider business mailing address

571 N YORK ST
ELMHURST IL
60126-1903
US

V. Phone/Fax

Practice location:
  • Phone: 630-833-8382
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number3274
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: