Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 016004853 | IL |
NPI | 1336147164 |
---|---|
Provider Name | Dr. Karona Monica Mason |
First Address | North Chicago, IL 60064-0610 |
Second Address | North Chicago, IL 60064-3090 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 12/04/2010 |