Provider Demographics
NPI:1689210205
Name:NORMITA PANGAN FIRST SURGEON ASSISTS LLC
Entity Type:Organization
Organization Name:NORMITA PANGAN FIRST SURGEON ASSISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRST ASSIST/SURGEON ASSIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMITA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PANGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-972-9179
Mailing Address - Street 1:439 FERDINAND AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130-3199
Mailing Address - Country:US
Mailing Address - Phone:312-972-9179
Mailing Address - Fax:
Practice Address - Street 1:800 BIESTERFIELD RD
Practice Address - Street 2:
Practice Address - City:ELK GROVE VLG
Practice Address - State:IL
Practice Address - Zip Code:60007-3361
Practice Address - Country:US
Practice Address - Phone:847-437-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1306383997OtherNPPES