Provider Demographics
NPI:1336147164
Name:MASON, KARONA MONICA (DPM)
Entity Type:Individual
Prefix:DR
First Name:KARONA
Middle Name:MONICA
Last Name:MASON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 610
Mailing Address - Street 2:
Mailing Address - City:NORTH CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60064-0610
Mailing Address - Country:US
Mailing Address - Phone:847-473-4357
Mailing Address - Fax:847-578-8671
Practice Address - Street 1:3471 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064-3090
Practice Address - Country:US
Practice Address - Phone:847-473-4357
Practice Address - Fax:847-578-8671
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016004853213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery