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

Individual provider Surgical Physician Assistant · NPI 1891708491

Mr. Gary Fisk, PA is a Surgical Physician Assistant in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

5405 N Knoxville Ave
Peoria, IL 61614-5016
Phone: (309) 691-4410
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 085000405 (IL)

Record details

NPI number1891708491
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 14, 2006
Last updated in NPPESJuly 8, 2007

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