Organization
MAS SOUND INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL MANCILLA RDMS (PRESIDENT)
(708) 715-0696
Entity
Organization
Contact information
Practice address
2234 S 10TH AVE, NORTH RIVERSIDE, IL 60546-1117
(708) 715-0696
Mailing address
2234 S 10TH AVE, NORTH RIVERSIDE, IL 60546-1117
(708) 715-0696
Taxonomy
Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
94512
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635154
BCBS
IL
01
—
7072707
AETNA
IL
Enumeration date
08/06/2008
Last updated
08/06/2008
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