SearchIllinoisSurgical Assistant

Alexandre Derevianko

NPI 1679987879 · on the registry since 2014

Practice

Address
1811 Arkansas Ave
Great Lakes, IL 60088
Phone
(401) 480-9807
Fax
(847) 733-5827

Registry record

Primary taxonomy
Surgical Assistant
246ZC0007X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2014-06-19

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois