MEDICARE: RAZAN MASRI

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1710729413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAZAN MASRI

Provider Business Mailing Address
First Line	:	289 MOUNT LANGLEY ST
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-7674
Country	:	US
Telephone Number	:	224-707-1098
Fax Number	:

Provider Business Practice Location Address
First Line	:	3432 W DIVERSEY AVE STE 22
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-1221
Country	:	US
Telephone Number	:	224-707-1098
Fax Number	:

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

Provider Enumeration Date	:	06/12/2024
Last Update Date	:	06/12/2024

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Directions to “ RAZAN MASRI ” Practice Location

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