Provider Demographics
NPI:1164718706
Name:PEAK SURGICAL ASSISTANT INC
Entity Type:Organization
Organization Name:PEAK SURGICAL ASSISTANT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KLARITIS
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:847-392-8800
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:MONEE
Mailing Address - State:IL
Mailing Address - Zip Code:60449-0309
Mailing Address - Country:US
Mailing Address - Phone:630-205-5206
Mailing Address - Fax:630-205-5206
Practice Address - Street 1:1188 ROYAL GLEN DR APT 315
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-6032
Practice Address - Country:US
Practice Address - Phone:630-205-5206
Practice Address - Fax:630-205-5206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty