Individual
MICHAEL ALAN MASTELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 S FAIRFIELD AVE, CHICAGO, IL 60608-1782
(773) 542-2000
Mailing address
125 S JEFFERSON ST, UNIT 3205, CHICAGO, IL 60661-3739
(219) 688-9208
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036141184
IL
208600000X
Surgery Physician
Primary
125063645
IL
Other
Enumeration date
07/07/2013
Last updated
11/16/2018
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