Provider Demographics
NPI:1235516642
Name:SAYAHCYST INC
Entity Type:Organization
Organization Name:SAYAHCYST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:S
Authorized Official - Last Name:NYKAZA
Authorized Official - Suffix:
Authorized Official - Credentials:RSA
Authorized Official - Phone:815-513-3654
Mailing Address - Street 1:725 GALLANT DR
Mailing Address - Street 2:
Mailing Address - City:MINOOKA
Mailing Address - State:IL
Mailing Address - Zip Code:60447-8835
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1802 N DIVISION ST
Practice Address - Street 2:STE 218
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-1182
Practice Address - Country:US
Practice Address - Phone:815-513-3654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL238.000280363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty