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General NPI Number Information
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NPI Number | 1669507034
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Entity Type | Organization
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Legal Business Name | CANCER THERAPY ASSOCIATES INC.
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1263 S HIGHLAND AVE SUITE 100
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City | LOMBARD
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State | IL
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Zip | 60148-4516
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Country | US
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Telephone | 630-261-0280
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Fax |
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Provider Business Mailing Address
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Address Line | 436 N COUNTY LINE RD
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City | HINSDALE
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State | IL
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Zip | 60521-3804
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Country | US
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Telephone | 630-261-0280
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN A. GREAGER II
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Credential | M.D.
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Telephone | 630-261-0280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | IL
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