Provider Demographics
NPI:1407005994
Name:PREMIER SURGICAL ASSISTANTS, INC.
Entity Type:Organization
Organization Name:PREMIER SURGICAL ASSISTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:RSA
Authorized Official - Phone:630-369-6200
Mailing Address - Street 1:568 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6642
Mailing Address - Country:US
Mailing Address - Phone:630-369-6200
Mailing Address - Fax:630-369-7200
Practice Address - Street 1:568 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6642
Practice Address - Country:US
Practice Address - Phone:630-369-6200
Practice Address - Fax:630-369-7200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty