Provider Demographics
NPI:1760781488
Name:SR SURGICAL ASSIST INC
Entity Type:Organization
Organization Name:SR SURGICAL ASSIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:PAWLOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:630-837-9461
Mailing Address - Street 1:37W716 STRATFORD LN
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60124-6750
Mailing Address - Country:US
Mailing Address - Phone:630-837-9461
Mailing Address - Fax:630-837-7640
Practice Address - Street 1:37W716 STRATFORD LN
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60124-6750
Practice Address - Country:US
Practice Address - Phone:630-837-9461
Practice Address - Fax:630-837-7640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-066757208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty