Healthcare Provider Details

I. General information

NPI: 1841326246
Provider Name (Legal Business Name): ONCOLOGY SPECIALISTS SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 N MILWAUKEE AVE
NILES IL
60714-3159
US

IV. Provider business mailing address

PO BOX 736
PARK RIDGE IL
60068-0736
US

V. Phone/Fax

Practice location:
  • Phone: 847-268-8200
  • Fax: 847-268-8030
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number StateIL

VIII. Authorized Official

Name: ANTHONY WALTERS
Title or Position: FINANCIAL DIRECTOR
Credential:
Phone: 847-268-8200