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General NPI Number Information
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NPI Number | 1497577746
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Entity Type | Organization
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Legal Business Name | ADVANCED CANCER CARE ASSOCIATES CORP
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 7420 CENTRAL AVE
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City | RIVER FOREST
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State | IL
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Zip | 60305-1800
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Country | US
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Telephone | 708-763-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 7420 CENTRAL AVE
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City | RIVER FOREST
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State | IL
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Zip | 60305-1800
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Country | US
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Telephone | 708-763-2700
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Fax | 708-488-9660
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | ISOKEN KOKO
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Credential |
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Telephone | 708-763-2700
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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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