Individual
DEREK ALLEN MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2649 E 75TH ST, CHICAGO, IL 60649-3835
(773) 356-9300
Mailing address
301 E COLORADO AVE, CASEY, IL 62420-1510
(217) 232-4449
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160005367
IL
Other
Enumeration date
04/12/2011
Last updated
04/12/2011
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