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General NPI Number Information
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NPI Number | 1598746299
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Entity Type | Organization
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Legal Business Name | M & K RADIATION ONCOLOGY
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 07/23/2010
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Provider Practice Location Address
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Address Line | 850 S 4TH ST
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City | WATSEKA
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State | IL
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Zip | 60970-1629
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Country | US
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Telephone | 815-432-0057
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Fax | 815-432-0059
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Provider Business Mailing Address
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Address Line | PO BOX 379
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City | ORLAND PARK
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State | IL
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Zip | 60462-0379
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Country | US
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Telephone | 708-774-2970
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Fax | 708-460-1117
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Authorized Official
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Title or Position | OFFICER
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Name | DR. SALWA F ASAAD
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Credential | MD
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Telephone | 708-774-2970
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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 |
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License Number State |
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