# MJ SURGASSISTS LLC

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

## Provider details

- **NPI number:** 1366184996
- **Authorized official:** JASON MADDELA (OWNER)
- **Authorized official phone:** (708) 205-7678

## Contact information

- **Practice address:** 2538 RAVINIA LN, WOODRIDGE, IL 60517-2218
- **Practice address phone:** (708) 205-7678
- **Mailing address:** 2538 RAVINIA LN, WOODRIDGE, IL 60517-2218

## Taxonomy

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

## Other

- **Enumeration date:** 04/13/2022
- **Last updated:** 04/13/2022