Provider Demographics
NPI:1114758562
Name:MASTRO, PAIGE H (PSYD)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:H
Last Name:MASTRO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14812 GREENVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-1994
Mailing Address - Country:US
Mailing Address - Phone:773-512-3897
Mailing Address - Fax:
Practice Address - Street 1:15 SPINNING WHEEL RD STE 426
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-7671
Practice Address - Country:US
Practice Address - Phone:630-323-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist