ENTERPRISE SURGICAL ASSISTANCE NPI 1992910988

NPI Information

NPI: 1992910988
Provider Name: ENTERPRISE SURGICAL ASSISTANCE
Classification: Physician Assistant - 363AS0400X
Entity Type: Organization

Specialization: Surgical

Address:
3249 OAK PARK AVE
BERWYN, IL
ZIP 60402
Phone: (708) 783-7696
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ENTERPRISE SURGICAL ASSISTANCE is a surgical physician assistant in Berwyn, IL. ENTERPRISE SURGICAL ASSISTANCE NPI is 1992910988. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3249 OAK PARK AVE
BERWYN, IL
ZIP 60402-429
Phone: (708) 783-7696
Fax: (773) 404-2086

The provider's authorized official is Randall David Ostroff .
The authorized official title is President and has the following contact phone number (773) 502-4221.

The enumeration date for this NPI number is 5/11/2007 and was last updated on 12/8/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01637103	OTHER	ILLINOIS	BLUE CROSS BLUE SHIELD OF IL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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