MEDICARE: ALLIANCE ONCOLOGY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	510G700087	OTHER	AL	MEDICARE AL GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063607125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE ONCOLOGY LLC

Provider Business Mailing Address
First Line	:	15055 COLLECTION CENTER DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60693-0001
Country	:	US
Telephone Number	:	256-383-3325
Fax Number	:	256-383-5911

Provider Business Practice Location Address
First Line	:	15055 COLLECTION CENTER DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60693-0150
Country	:	US
Telephone Number	:	256-383-3325
Fax Number	:	256-383-5911

Authorized Official
Title or Position	:	CFO
Name	:	MICHAEL CRAIG WEEKS
Credential	:
Telephone Number	:	256-383-3325

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	04/01/2014

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Directions to “ALLIANCE ONCOLOGY LLC ” Practice Location

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