Individual
YURIY SEREMBYTSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11255 W PLAINFIELD RD, INDIAN HEAD PARK, IL 60525-3735
(708) 420-3203
Mailing address
11255 W PLAINFIELD RD, INDIAN HEAD PARK, IL 60525-3735
(708) 420-3203
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
238.000044
IL
363AS0400X
Surgical Physician Assistant
Primary
238.000044
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538275508
SURGICAL ASSISTANT
IL
Enumeration date
08/22/2006
Last updated
09/23/2018
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