Healthcare Provider Details

I. General information

NPI: 1962436204
Provider Name (Legal Business Name): ONCOLOGY OF NORTHSHORE CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 GOLF RD
ROLLING MEADOWS IL
60008
US

IV. Provider business mailing address

2000 GOLF RD
ROLLING MEADOWS IL
60008-4216
US

V. Phone/Fax

Practice location:
  • Phone: 847-871-1800
  • Fax: 847-629-4937
Mailing address:
  • Phone: 847-871-1800
  • Fax: 847-871-1811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BASSAM F MATAR
Title or Position: OWNER/DR
Credential: MD
Phone: 847-871-1800