Provider Demographics
NPI:1659077725
Name:GYUZELEV MD SURGICAL ASSISTANCE LLC
Entity Type:Organization
Organization Name:GYUZELEV MD SURGICAL ASSISTANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRST SURGICAL ASSISTANT/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GYUZELEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-307-5005
Mailing Address - Street 1:314 WILMINGTON CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-7859
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:314 WILMINGTON CT
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-7859
Practice Address - Country:US
Practice Address - Phone:815-307-5005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic AssistantGroup - Multi-Specialty