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Individual

DR. JOHN MASSIMILIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1201 S MAIN ST, DEPT: ED, CROWN POINT, IN 46307-8481
(219) 757-6310
(219) 757-6312
Mailing address
211 DEVON DR, BURR RIDGE, IL 60527-8309
(630) 655-1055
(630) 655-8966

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02001829A
IN
207P00000X
Emergency Medicine Physician
IL

Other

Enumeration date
04/26/2006
Last updated
07/08/2007
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