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General NPI Number Information
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NPI Number | 1922287358
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Entity Type | Organization
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Legal Business Name | LUDAG LLC, DBA CANCER TREATMENT GROUP
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 100 PROVENA WAY
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City | BOURBONNAIS
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State | IL
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Zip | 60914-4796
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Country | US
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Telephone | 815-937-2460
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 85327
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City | CHICAGO
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State | IL
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Zip | 60689-5327
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Country | US
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Telephone | 800-329-1906
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT T WOODBURN
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Credential | MD
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Telephone | 574-271-2558
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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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