Active NPI
Sviatoslav Tsebryk, RSA
- Surgical Physician Assistant
- Mokena, IL
National Provider Identifier
1487580643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 238010984
- Practice address
- 19015 S Jodi Rd Ste H
Mokena, IL 60448-8534 - Phone
- (708) 995-5418
- Fax
- (832) 804-8886
- NPI assigned
- Jun 23, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 238010984 | IL | Primary |
Addresses
Primary practice location
19015 S Jodi Rd Ste H
Mokena, IL 60448-8534
Mailing address
19015 S Jodi Rd Ste H
Mokena, IL 60448-8534
Phone (708) 995-5418
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 238010984 | Other | IL | ILLINOIS REGISTRATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782172800000",
"number": "1487580643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19015 S JODI RD STE H",
"city": "MOKENA",
"state": "IL",
"postal_code": "604488534",
"telephone_number": "708-995-5418",
"fax_number": "832-804-8886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19015 S JODI RD STE H",
"city": "MOKENA",
"state": "IL",
"postal_code": "604488534",
"telephone_number": "708-995-5418",
"fax_number": "832-804-8886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TSEBRYK",
"first_name": "SVIATOSLAV",
"credential": "RSA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-06-23",
"last_updated": "2026-06-23",
"certification_date": "2026-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physician Assistant, Surgical",
"state": "IL",
"license": "238010984",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS REGISTRATION",
"identifier": "238010984",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mokena, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.