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General NPI Number Information
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NPI Number | 1841107745
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Entity Type | Organization
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Legal Business Name | PROASSISTING SERVICES LLC
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 18761 CHESTNUT CT
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City | MOKENA
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State | IL
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Zip | 60448-9501
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Country | US
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Telephone | 708-979-6368
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Fax |
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Provider Business Mailing Address
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Address Line | 18761 CHESTNUT CT
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City | MOKENA
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State | IL
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Zip | 60448-9501
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Country | US
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Telephone | 708-979-6368
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOSE BALBOA
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Credential | RSA
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Telephone | 708-979-6368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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