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General NPI Number Information
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NPI Number | 1538120381
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Entity Type | Organization
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Legal Business Name | HEMATOLOGY ONCOLOGY ASSOCIATES OF ILLINOIS LLC
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 08/20/2012
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Provider Practice Location Address
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Address Line | 676 N ST CLAIR SUITE 2140
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City | CHICAGO
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State | IL
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Zip | 60611
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Country | US
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Telephone | 312-664-5400
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Fax | 312-664-5854
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Provider Business Mailing Address
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Address Line | 25068 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 | 847-240-9093
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Authorized Official
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Title or Position | STATE BUSINESS ADMINISTRATOR
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Name | RICK T PEREZ
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Credential |
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Telephone | 847-585-7012
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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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