MEDICARE: MR. SHERYAR MASUD D.C.

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	111N00000X	Chiropractor		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	04527125	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1831140573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHERYAR MASUD D.C.

Provider Business Mailing Address
First Line	:	525 TYLER RD
Second Line	:	UNIT R-1
City	:	ST CHARLES
State	:	IL
Zip	:	60174-3305
Country	:	US
Telephone Number	:	630-443-4411
Fax Number	:	630-443-7351

Provider Business Practice Location Address
First Line	:	525 TYLER RD
Second Line	:	UNIT R-1
City	:	ST CHARLES
State	:	IL
Zip	:	60174-3305
Country	:	US
Telephone Number	:	630-443-4411
Fax Number	:	630-443-7351

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	07/08/2007

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Directions to “ MR. SHERYAR MASUD D.C.” Practice Location

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