Gary Fisk, PA
Surgical PA · Peoria, IL
UnclaimedPANPI 1891708491
- Primary taxonomy
- 363AS0400X
- Enumerated
- 2006-08-14
- Practice location
- Peoria, IL
- Last NPPES update
- 2007-07-08
State licenses
- IL · Physician assistant · LICENSED PHYSICIAN ASSISTANTInactivethrough 2016
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.