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NPI Code Detail

MEDICARE: MASSARO SURGICAL, LTD

MEDICARE: MASSARO SURGICAL, LTD
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
1261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1053527747
Entity Type Code : Organization
Provider Name (Legal Business Name) : MASSARO SURGICAL, LTD
Provider Business Mailing Address
First Line : 113 W MAIN ST
Second Line :
City : CARY
State : IL
Zip : 60013-2718
Country : US
Telephone Number : 847-639-5800
Fax Number : 847-639-2980
Provider Business Practice Location Address
First Line : 113 W MAIN ST
Second Line :
City : CARY
State : IL
Zip : 60013-2718
Country : US
Telephone Number : 847-639-5800
Fax Number : 847-639-2980
Authorized Official
Title or Position : OWNER
Name : DR. JAMES C MASSARO
Credential : DPM
Telephone Number : 847-639-5800
Provider Enumeration Date : 05/16/2007
Last Update Date : 10/26/2007

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Directions to “MASSARO SURGICAL, LTD ” Practice Location

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