Healthcare Provider Details

I. General information

NPI: 1841107745
Provider Name (Legal Business Name): PROASSISTING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18761 CHESTNUT CT
MOKENA IL
60448-9501
US

IV. Provider business mailing address

18761 CHESTNUT CT
MOKENA IL
60448-9501
US

V. Phone/Fax

Practice location:
  • Phone: 708-979-6368
  • Fax:
Mailing address:
  • Phone: 708-979-6368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: JOSE BALBOA
Title or Position: CEO
Credential: RSA
Phone: 708-979-6368