CANCER CARE SPECIALISTS, LTD. (NPI# 1083704449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083704449 |
| Entity Type | Organization |
| Organization Name | CANCER CARE SPECIALISTS, LTD. |
| Practice Address |
16532 S. Oak Park Ave Suite 102 Tinley Park IL 60477-2280 |
| Practice Telephone | 7083421576 |
| Practice Fax Number | 7083421465 |
| Mailing Telephone | 7083421576 |
| Mailing Fax Number | 7083421465 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2013-03-20 |
| Authorized Official Name | JOHN MICHAEL MCKEOWN (PRESIDENT) |
| Authorized Official Telephone | 7083421576 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
36046718 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 340362537 | 05 |
| Street Address |
16532 S. OAK PARK AVE SUITE 102 |
| City | TINLEY PARK |
| State | IL |
| Zip Code | 60477-2280 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659461010 | John Michael Mckeown | Internal Medicine | 16532 S. Oak Park Ave, Suite 102, Tinley Park, IL 60477-2280 | 2006-10-13 |
| 1033131131 | Ruben Chuquimia | Internal Medicine | 16532 S. Oak Park Ave, Suite 200, Tinley Park, IL 60477-2273 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013522366 | Joshua Gruenke | Physical Therapist | 17129 S. Harlem Avenue, Tinley Park, IL 60477 | 2020-09-14 |
| 1881229656 | Sherrie Lynn Tsang | Massage Therapist | 7925 West 171st Street, Tinley Park, IL 60477 | 2020-03-11 |
| 1437782117 | Du Page Medical Group Ltd | Durable Medical Equipment & Medical Supplies | 17129 S Harlem Ave. Ste B3, Tinley Park, IL 60477 | 2020-02-20 |
| 1356998561 | Rasa Vaskeviciute | Physical Therapist | 17129 So Harlem, Tinley Park, IL 60477 | 2019-08-22 |
| 1538728258 | Michelle Anne Wisen | Physical Therapy Assistant | 17129 South Harlem, Suite B3, Tinley Park, IL 60477 | 2019-06-06 |
| 1073006151 | Danielle Lyon | Counselor | 6801 West 180th Court, Tinley Park, IL 60477 | 2018-06-13 |
| 1316445794 | Yvonne Tran | Physical Therapist | 17129 S Harlem Ave, Tinley Park, IL 60477 | 2018-01-31 |
| 1326574591 | Nicholas Barker | Chronic Disease Hospital | 7859 Joliet Drive North, Tinley Park, IL 60477 | 2017-05-10 |
| 1982063632 | Nicole Kristine Demarco | Specialist/Technologist | 16317 Clark Ln, Tinley Park, IL 60477 | 2016-02-22 |
| 1376900571 | Ucp Seguin Greater Chicago | Foster Care Agency | 7550 W. 183rd, Tinley Park, IL 60477 | 2016-01-20 |
| Find all providers in zip 60477 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| 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. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730634700 | Liyun Huang | Internal Medicine | 17495 South La Grange Rd, Tinley Park, IL 60487 | 2016-08-19 |
| 1659461010 | John Michael Mckeown | Internal Medicine | 16532 S. Oak Park Ave, Suite 102, Tinley Park, IL 60477-2280 | 2006-10-13 |
| 1598750101 | Saoud Loutfi | Internal Medicine | 17495 La Grange Rd, Tinley Park, IL 60487-7581 | 2005-09-20 |
| 1992797047 | Vasia A Ahmed | Internal Medicine | 17333 La Grange Rd Ste 200, Tinley Park, IL 60487-7510 | 2005-08-16 |
| 1316236524 | Mylene Hernandez Remo | Internal Medicine | 17333 La Grange Rd Ste 200, Tinley Park, IL 60487-7510 | 2011-03-29 |
| 1255656948 | Surekha Boddipalli | Internal Medicine | 17495 La Grange Rd, Tinley Park, IL 60487-7581 | 2010-04-06 |
| 1760625867 | Alpha Med Physicians Group, LLC | Internal Medicine | 17333 La Grange Rd, Suite 200, Tinley Park, IL 60487-7502 | 2009-04-20 |
| 1427218452 | Vasantha Kumaraiah,md,sc | Internal Medicine | 17732 Oak Park Ave, Suite E, Tinley Park, IL 60477-3934 | 2008-06-12 |
| 1427255447 | Shadi Latta | Internal Medicine | 17333 La Grange Rd Ste 200, Tinley Park, IL 60487-7510 | 2007-07-02 |
| 1588607923 | Monroe Medical Associates, Sc | Internal Medicine | 6701 159th St, Suite 1, Tinley Park, IL 60477-1758 | 2006-06-14 |
| Find all providers in TINLEY PARK | ||||
| City | TINLEY PARK |
| Zip Code | 60477 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.