Provider Demographics
NPI:1336895705
Name:PRASKOV, SIYANA KOLEVA (PA-C)
Entity Type:Individual
Prefix:
First Name:SIYANA
Middle Name:KOLEVA
Last Name:PRASKOV
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SIYANA
Other - Middle Name:
Other - Last Name:DANAILOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4405 WEAVER PKWY
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3269
Mailing Address - Country:US
Mailing Address - Phone:630-352-5450
Mailing Address - Fax:630-938-8849
Practice Address - Street 1:4405 WEAVER PKWY
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3269
Practice Address - Country:US
Practice Address - Phone:630-352-5450
Practice Address - Fax:630-938-8849
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant