Healthcare Provider Details
I. General information
NPI: 1992476881
Provider Name (Legal Business Name): FIRST SURGICAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/21/2021
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
830 E RAND RD STE 7
MOUNT PROSPECT IL
60056-2560
US
IV. Provider business mailing address
PO BOX 217
GLENVIEW IL
60025-0217
US
V. Phone/Fax
- Phone: 847-656-5245
- Fax:
- Phone: 847-656-5245
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 246ZC0007X |
| Taxonomy | Surgical Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FRED
JENDO
Title or Position: CEO
Credential: C-SA
Phone: 773-401-6715