MEDICARE: CLIO MUSURAKIS MD

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	036.156041	IL

General Provider Information

NPI Number	:	1639664980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLIO MUSURAKIS MD

Provider Business Mailing Address
First Line	:	7702 N ALPINE RD
Second Line	:
City	:	LOVES PARK
State	:	IL
Zip	:	61111-3107
Country	:	US
Telephone Number	:	815-971-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 CHESTNUT STREET
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02492-3328
Country	:	US
Telephone Number	:	617-667-9344
Fax Number	:

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

Provider Enumeration Date	:	06/28/2018
Last Update Date	:	01/19/2026

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