Provider Demographics
NPI:1194885137
Name:UNITED SURGICAL ASSISTANTS, INC
Entity type:Organization
Organization Name:UNITED SURGICAL ASSISTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-933-3955
Mailing Address - Street 1:750 ALMAR PKWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-2315
Mailing Address - Country:US
Mailing Address - Phone:815-933-3955
Mailing Address - Fax:815-933-3944
Practice Address - Street 1:750 ALMAR PKWY
Practice Address - Street 2:SUITE 205
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-2315
Practice Address - Country:US
Practice Address - Phone:815-933-3955
Practice Address - Fax:815-933-3944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty