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Organization
JSA OF ILLINOIS PC
Active
Organization
JSA OF ILLINOIS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN SCHAKER (BILLING DIRECTOR)
(678) 983-4479
Entity
Organization
Contact information
Practice address
309 E RAND RD, SUITE 347, ARLINGTON HEIGHTS, IL 60004-3103
(678) 983-4479
Mailing address
PO BOX 543, ALPHARETTA, GA 30009-0543
(678) 983-4479
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
—
NULL
246ZC0007X
Surgical Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
NULL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
05/11/2011
Last updated
08/16/2011
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