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General NPI Number Information
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NPI Number | 1558526194
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Entity Type | Individual
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Provider Name | HUMA MASOOD M.D
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Gender | Female
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 456 25TH AVE
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City | BELLWOOD
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State | IL
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Zip | 60104-1961
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Country | US
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Telephone | 708-467-7254
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Fax | 815-642-5697
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Provider Business Mailing Address
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Address Line | PO BOX 746721
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City | ATLANTA
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State | GA
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Zip | 30374-6721
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Country | US
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Telephone | 312-733-9730
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Fax | 773-866-8014
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 238113
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036.166534
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License Number State | IL
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