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DR. MARIO MASSULLO
NPI 1447454657
Internal Medicine - Cardiovascular Disease in Kankakee, IL

Active since June 12, 2007
455 W. COURT ST., SUITE 202, KANKAKEE, IL 60441(805) 936-3200(815) 936-3203 Get Directions Write a Review

NPPES record last updated: June 12, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Mario Massullo NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARIO MASSULLO (NPI 1447454657) is a healthcare organization registered as a cardiovascular disease in Kankakee, Illinois and active in the NPI registry since June 2007. The organization lists Pat Devries, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1447454657
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameADVANCED CARDIOVASCULAR SERVICES
Location Address455 W. COURT ST., SUITE 202Kankakee, IL 60441
Mailing AddressPo Box 882Kankakee, IL 60901-0882 · (815) 936-3200 · Fax (815) 936-3203
Phone(805) 936-3200
Fax(815) 936-3203
Organization SubpartNo
Authorized OfficialPat DevriesBilling Manager · (708) 460-5000
Enumeration DateJune 12, 2007
Last NPPES UpdateJune 12, 2008
✔ NPI 1447454657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
455 W. COURT ST., Kankakee, IL 60441
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Other Names 1

Doing Business AsDr. Mario Massullo

Other Identifiers 5

Other0004632018IL · Blue Cross
OtherP00059541IL · Railroad Medicare
Medicaid036082059IL
Medicare PIN203483IL
Medicare UPINF64243IL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Advanced Cardiovascular Services's NPI number?

The NPI number for Advanced Cardiovascular Services is 1447454657. It was assigned to this organization in the NPPES registry on June 12, 2007. The provider is doing business as Dr. Mario Massullo.

Where is Advanced Cardiovascular Services located?

Advanced Cardiovascular Services is located at 455 W. Court St. Suite 202, Kankakee, IL 60441. The listed phone number is (805) 936-3200.

What is Advanced Cardiovascular Services's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

When was this NPI record last updated?

The NPPES record for Advanced Cardiovascular Services was last updated on June 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.