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Organization
MJ SURGASSISTS LLC
Active
Organization
MJ SURGASSISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON MADDELA (OWNER)
(708) 205-7678
Entity
Organization
Contact information
Practice address
2538 RAVINIA LN, WOODRIDGE, IL 60517-2218
(708) 205-7678
Mailing address
2538 RAVINIA LN, WOODRIDGE, IL 60517-2218
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
NULL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
04/13/2022
Last updated
04/13/2022
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