Healthcare Provider Details

I. General information

NPI: 1033197207
Provider Name (Legal Business Name): VALLEY CANCER CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E 1ST ST
SPRING VALLEY IL
61362
US

IV. Provider business mailing address

PO BOX 15040
EVANSVILLE IN
47716-0040
US

V. Phone/Fax

Practice location:
  • Phone: 815-664-4141
  • Fax: 815-663-1818
Mailing address:
  • Phone: 812-962-6413
  • Fax: 812-477-4153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. NEELIMA D KABRE
Title or Position: PRESIDENT
Credential: MD
Phone: 815-664-4141