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General NPI Number Information
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NPI Number | 1922031418
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Entity Type | Organization
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Legal Business Name | NUCLEAR ONCOLOGY, SC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2614 W JEFFERSON ST
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City | JOLIET
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State | IL
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Zip | 60435-6433
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Country | US
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Telephone | 815-730-3537
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Fax | 815-730-3020
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Provider Business Mailing Address
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Address Line | PO BOX 74
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City | HIAWATHA
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State | IA
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Zip | 52233-0074
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Country | US
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Telephone | 319-826-3763
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Fax | 888-609-6019
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Authorized Official
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Title or Position | GROUP ADMINISTRATOR
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Name | MR. ROGER S KRUEGER
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Credential |
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Telephone | 630-734-9560
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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 | IL
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