Individual
DR. LESLIE ANN MASOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4945 FOREST AVE, DOWNERS GROVE, IL 60515-3509
(630) 408-6992
Mailing address
1034 WARREN AVE, DOWNERS GROVE, IL 60515-3601
(630) 408-6992
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036115294
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633122
BCBS PROVIDER NUMBER
IL
01
—
036115294
STATE LIC NUMBER
IL
01
—
4673170001
DMERC GROUP
IL
01
—
P00444353/CK6882
RAILROAD MEDICARE
IL
Enumeration date
05/15/2007
Last updated
02/16/2022
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