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General NPI Number Information
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NPI Number | 1215954029
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Entity Type | Organization
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Legal Business Name | INTERMED ONCOLOGY
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 17901 GOVERNORS HWY
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City | HOMEWOOD
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State | IL
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Zip | 60430-1144
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Country | US
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Telephone | 708-957-2100
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Fax | 708-957-4714
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Provider Business Mailing Address
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Address Line | 17901 GOVERNORS HWY
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City | HOMEWOOD
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State | IL
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Zip | 60430-1144
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Country | US
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Telephone | 708-957-2100
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Fax | 708-957-4714
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YUNUS T NOMANBHOY
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Credential | M.D.
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Telephone | 708-957-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | IL
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