MEDICARE: DR. NICOLE MARIE MASSE 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	207VM0101X	Maternal & Fetal Medicine Physician	036.158814	IL

General Provider Information

NPI Number	:	1720492317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLE MARIE MASSE M.D.

Provider Business Mailing Address
First Line	:	1555 BARRINGTON RD STE 215
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169-1063
Country	:	US
Telephone Number	:	847-490-6960
Fax Number	:

Provider Business Practice Location Address
First Line	:	1555 BARRINGTON RD STE 215
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169-1063
Country	:	US
Telephone Number	:	847-490-6960
Fax Number	:

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

Provider Enumeration Date	:	06/11/2014
Last Update Date	:	05/19/2022

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