Individual
KATHLEEN MASELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N., AGNP-C
Contact information
Practice address
1101 S STATE ST, 603, CHICAGO, IL 60605-3175
(773) 230-8726
(224) 610-7096
Mailing address
1101 S STATE ST, 603, CHICAGO, IL 60605-3175
(773) 230-8726
(224) 610-7096
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
209.015111
IL
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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