Organization
CHIEF SURGICAL ASSISTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KESHAWN GARDNER CSFA (SURGICAL ASSISTANT)
(708) 215-1604
Entity
Organization
Contact information
Practice address
1248 BERRY LN, FLOSSMOOR, IL 60422
(708) 215-1604
Mailing address
1248 BERRY LN, FLOSSMOOR, IL 60422-1410
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
11/25/2017
Last updated
07/10/2018
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