Healthcare Provider Details

I. General information

NPI: 1336469113
Provider Name (Legal Business Name): CENTRAL SURGICAL ASSISTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 06/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22028 W LAKELAND TRL
PLAINFIELD IL
60544-6014
US

IV. Provider business mailing address

22028 W LAKELAND TRL
PLAINFIELD IL
60544-6014
US

V. Phone/Fax

Practice location:
  • Phone: 630-440-4410
  • Fax: 815-886-6776
Mailing address:
  • Phone: 630-440-4410
  • Fax: 815-886-6776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number238.000072
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number238.000072
License Number StateIL

VIII. Authorized Official

Name: ADNANUL A ARAIN
Title or Position: PRESIDENT
Credential: RSA
Phone: 630-440-4410