Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Harold Lisandro Mendoza Moreno, RSA

Individual provider Surgical Physician Assistant · NPI 1366879330

Harold Lisandro Mendoza Moreno, RSA is a Surgical Physician Assistant in Plainfield, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2013
Specialties on file
2

Practice location Address checks out

26536 W Countryside Ln
Plainfield, IL 60585-2324
Phone: (630) 258-0401
Fax: (779) 234-9841
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 238.000377 (IL)
Surgical Assistant Taxonomy 246ZC0007X · Licence 238.000377 (IL)

Record details

NPI number1366879330
Entity typeIndividual (Type 1)
GenderMale
Credentials RSA
Sole proprietorYes
NPI enumeratedOctober 4, 2013
Last updated in NPPESMarch 19, 2024
Certification dateMarch 19, 2024

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