OrganizationActive
Advanced Cardiovascular Services
NPI 1447454657 · Cardiovascular Disease Physician · Kankakee, IL
Provider details
- NPI number
- 1447454657
- Entity type
- Organization
- Primary specialty
- Cardiovascular Disease PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Pat Devries, Billing Manager(708) 460-5000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
455 W. Court St.
Suite 202
Kankakee, IL 60441
Phone: (805) 936-3200
Fax: (815) 936-3203
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 882
Kankakee, IL 60901-0882
Other names (DBA / former)
- Doing business as
- Dr. Mario Massullo
Registry dates
- Enumerated
- 2007-06-12
- Last updated
- 2008-06-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.