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MR. GARY FISK PA
NPI 1891708491
Physician Assistant - Surgical in Peoria, IL

Active since August 14, 2006
5405 N KNOXVILLE AVE, PEORIA, IL 61614(309) 691-4410 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Gary Fisk Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. GARY FISK PA (NPI 1891708491) is an individual surgical provider in Peoria, Illinois, licensed in Illinois (085000405) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1891708491
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. GARY FISKCredential: PA
Location Address5405 N KNOXVILLE AVEPeoria, IL 61614-5016
Mailing Address5405 N Knoxville AvePeoria, IL 61614-5016 · (309) 691-4410
Phone(309) 691-4410
Sole ProprietorNo
Enumeration DateAugust 14, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1891708491 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in IL · 085000405
5405 N KNOXVILLE AVE, Peoria, IL 61614
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Other Identifiers 2

Medicare ID-Type UnspecifiedK03025IL
Medicare UPINR78359IL

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTINE C PERKS MD
Internal Medicine (Cardiovascular Disease)
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-4410
RICHARD S SEABOCH PA
Physician Assistant
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-4410
VIJAYASREE PALERU M.D.
Internal Medicine (Cardiovascular Disease)
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-4410
DEAN SCHMIDT ACNP
Nurse Practitioner (Acute Care)
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-4410
GERRI HELLHAKE-HALL FNP
Nurse Practitioner (Family)
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-4410
DR. NEIL KENT WISE MD
Internal Medicine (Cardiovascular Disease)
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-4410
MICHAEL GRZESKOWIAK
Internal Medicine (Cardiovascular Disease)
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-4410
MRS. WHITNEY RENEE ANDAL APN
Family Medicine
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 624-9960

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gary Fisk's NPI number?

The NPI number for Gary Fisk is 1891708491. It was assigned to this individual provider in the NPPES registry on August 14, 2006.

Where is Gary Fisk located?

Gary Fisk practices at 5405 N Knoxville Ave, Peoria, IL 61614. The listed phone number is (309) 691-4410.

What is Gary Fisk's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Gary Fisk was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.