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ILLINOIS CANCER SPECIALISTS NPI 1922114453


NPI Information

NPI: 1922114453
Provider Name: ILLINOIS CANCER SPECIALISTS

Former Legal Business Name: FOX VALLEY HEMATOLOGY INC

Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

Address:
4305 W MEDICAL CENTER DR
STE 1
MCHENRY, IL
ZIP 60050
Phone: (815) 363-0066
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ILLINOIS CANCER SPECIALISTS is a hematology and oncology internal medicine in Mchenry, IL. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. ILLINOIS CANCER SPECIALISTS NPI is 1922114453. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Fox Valley Hematology Inc.

The provider's business location address is:

4305 W MEDICAL CENTER DR
STE 1
MCHENRY, IL
ZIP 60050-425
Phone: (815) 363-0066
Fax: (815) 385-2812

The provider's authorized official is David Hakimian .
The authorized official title is President and has the following contact phone number (847) 827-9060.

The enumeration date for this NPI number is 8/21/2006 and was last updated on 3/12/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RH0003XInternal MedicineHematology & OncologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1582420MEDICARE UPINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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