Individual
GREGORY MARTIN KASSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1620 W HARRISON ST, CHICAGO, IL 60612-3801
(312) 942-5000
Mailing address
1620 W HARRISON ST, CHICAGO, IL 60612-3801
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209021930
IL
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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