Individual
TERRY MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2850 S WABASH AVE, SUITE 106, CHICAGO, IL 60616-2955
(312) 842-4400
(312) 842-4595
Mailing address
2850 S WABASH AVE, SUITE 106, CHICAGO, IL 60616-2955
(312) 842-4400
(312) 842-4595
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036059147
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621679
BCBS OF IL
IL
05
—
036059147
—
IL
Enumeration date
12/22/2005
Last updated
04/20/2010
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