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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MARIO GERARD MASSULLO, D.O.

Active Sole Proprietor

MARIO GERARD MASSULLO, D.O. is a Cardiovascular Disease healthcare provider located in KANKAKEE, Illinois. NPI 1043228158 is currently active in the NPPES registry. Verify at CMS.

Cardiovascular Disease · KANKAKEE, IL

Registration Details

NPI Number
1043228158
Provider Type
Individual
Gender
Male
NPI Issued
Aug 4, 2006 (19.881190297672 yrs)
Last Updated
Oct 27, 2021
Licenses
036082059 (IL)
036082059 (IL)
036082059 (IL)
Sole Proprietor
Yes

Practice Information

Address
1710 W. COURT ST.
KANKAKEE, IL, 60901
Browse IL providers · Browse ZIP 60901
Phone
8159363200
Fax
8159363203
Primary Specialty
Cardiovascular Disease
207RC0000X
Additional Specialty
Cardiovascular Disease

Other Cardiovascular Disease Providers in KANKAKEE, IL

Name Credential NPI
DR. LYNN G BROWN MD 1013962182
DR. PHILIP G HAYS M.D 1275540536
VIKAS K. PATEL MD 1235349598
DR. NHA T HUYNH DO 1376709758
GAURANG GUJARATHI DO 1124314349
SEBAN LIU D.O. 1174904304
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.