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General NPI Number Information
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NPI Number | 1134235666
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Entity Type | Organization
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Legal Business Name | ILLINOIS CANCER SPECIALISTS
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 03/12/2014
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Provider Practice Location Address
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Address Line | 3703 DOTY RD STE 6
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City | WOODSTOCK
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State | IL
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Zip | 60098-7517
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Country | US
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Telephone | 815-334-9154
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Fax | 815-334-1017
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Provider Business Mailing Address
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Address Line | 25070 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1250
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Country | US
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Telephone | 847-585-7000
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Fax | 847-240-0622
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Authorized Official
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Title or Position | PRACTICE PRESIDENT
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Name | DR. DAVID HAKIMIAN
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Credential |
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Telephone | 847-827-9060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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