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General NPI Number Information
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NPI Number | 1972824142
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Entity Type | Organization
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Legal Business Name | ILLINOIS PROTON CENTER LLC
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Dates
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Enumeration Date | 06/22/2010
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 4455 WEAVER PKWY
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City | WARRENVILLE
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State | IL
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Zip | 60555-3269
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Country | US
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Telephone | 630-821-6400
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Fax | 630-821-6474
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Provider Business Mailing Address
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Address Line | DEPT 5777
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City | CAROL STREAM
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State | IL
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Zip | 60122
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP, HOSPITAL REVENUE CYCLE, NMHC
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Name | MICHAEL MULLEN
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Credential |
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Telephone | 630-938-6076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0203X
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Taxonomy Name | Radiation Oncology Clinic/Center
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License Number |
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License Number State |
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