# SKY SURGICAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215692173
- **Authorized official:** MR. YOGESH SUTRAVE (OWNER)
- **Authorized official phone:** (920) 378-9266

## Contact information

- **Practice address:** 6743 S POINTE DR UNIT 3C, TINLEY PARK, IL 60477-6291
- **Practice address phone:** (920) 378-9266
- **Mailing address:** PO BOX 523, TINLEY PARK, IL 60477-0523
- **Mailing address phone:** (920) 378-9266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | — | NULL | Yes |
| 363AS0400X | Surgical Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 11/05/2021
- **Last updated:** 11/05/2021