MEDICARE: DR. DEEBA MASOOD M.D.

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
1	207K00000X	Allergy & Immunology Physician	036085010	IL

General Provider Information

NPI Number	:	1396787339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEEBA MASOOD M.D.

Provider Business Mailing Address
First Line	:	870 N MILWAUKEE AVE
Second Line	:
City	:	VERNON HILLS
State	:	IL
Zip	:	60061-1521
Country	:	US
Telephone Number	:	847-535-7647
Fax Number	:

Provider Business Practice Location Address
First Line	:	870 N MILWAUKEE AVE
Second Line	:
City	:	VERNON HILLS
State	:	IL
Zip	:	60061-1521
Country	:	US
Telephone Number	:	847-535-7647
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	07/21/2022

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