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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

HAROLD LISANDRO MENDOZA MORENO, RSA

Active Sole Proprietor

HAROLD LISANDRO MENDOZA MORENO, RSA is a Surgical Physician Assistant healthcare provider located in PLAINFIELD, Illinois. NPI 1366879330 is currently active in the NPPES registry. Verify at CMS.

Surgical Physician Assistant · PLAINFIELD, IL

Registration Details

NPI Number
1366879330
Provider Type
Individual
Gender
Male
NPI Issued
Oct 4, 2013 (12.819352242605 yrs)
Last Updated
Mar 19, 2024
Licenses
238.000377 (IL)
238.000377 (IL)
Sole Proprietor
Yes

Practice Information

Address
26536 W COUNTRYSIDE LN
PLAINFIELD, IL, 605852324
Browse IL providers · Browse ZIP 60585
Phone
6302580401
Fax
7792349841
Primary Specialty
Surgical Physician Assistant
363AS0400X
Additional Specialty
Clinical Chemistry Technician

Other Surgical Physician Assistant Providers in PLAINFIELD, IL

Name Credential NPI
ROHINI AVVARU SA-C 1346448073
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.