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General NPI Number Information
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NPI Number | 1154369643
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Entity Type | Organization
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Legal Business Name | RADIATION ONCOLOGY, S.C.
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 05/24/2019
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Provider Practice Location Address
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Address Line | 17333 LA GRANGE RD STE 100
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City | TINLEY PARK
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State | IL
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Zip | 60487-7510
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Country | US
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Telephone | 708-748-9918
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Fax | 708-448-7530
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Provider Business Mailing Address
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Address Line | 17333 LA GRANGE RD STE 100
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City | TINLEY PARK
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State | IL
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Zip | 60487-7510
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Country | US
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Telephone | 708-748-9918
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Fax | 708-448-7530
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Authorized Official
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Title or Position | PRESIDENT
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Name | SYED JAVED SHIRAZI
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Credential | M.D.
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Telephone | 708-448-9393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 042002397
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License Number State | IL
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