COMMUNITY CANCER CENTER LLC (NPI# 1144506072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144506072 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CANCER CENTER LLC |
| Practice Address |
407 E. Vernon Avenue Normal IL 61761 |
| Practice Telephone | 3094518500 |
| Practice Fax Number | 3094512299 |
| Mailing Telephone | 3094518500 |
| Mailing Fax Number | 3094512231 |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2013-11-20 |
| Authorized Official Name | JOSEPH PROSSER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3094518500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| Street Address |
407 E. VERNON AVENUE |
| City | NORMAL |
| State | IL |
| Zip Code | 61761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1679108971 | Krystal Halliday | Occupational Therapist | 1815 N Towanda Barnes Rd, Normal, IL 61761 | 2020-03-06 |
| 1265915474 | Laine E Burek | Nurse Practitioner | 1765 Bradford Ln., Normal, IL 61761 | 2018-09-13 |
| 1801389986 | Ashley Michelle James | Specialist/Technologist | 347 S. University St, Normal, IL 61761 | 2018-06-12 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1497275069 | Mclean County Nursing Home | Non-emergency Medical Transport (VAN) | 901 N. Main St, Normal, IL 61761 | 2017-06-23 |
| 1235673666 | Megan Threm | Registered Nurse | 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 | 2016-12-04 |
| 1437513553 | Tiesha Smith | Specialist | 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 | 2016-04-06 |
| 1285031658 | New Day Recovery | Community/Behavioral Health | 402 Summit, Normal, IL 61761 | 2014-12-01 |
| 1174927701 | Alyssa Marie Bruck | Occupational Therapist | 700 N Walnut St, Normal, IL 61761 | 2014-10-10 |
| Find all providers in zip 61761 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427000207 | Shermian Antoinette Woodhouse | Radiology | 407 E Vernon Avenue, Normal, IL 61761-3813 | 2006-05-17 |
| 1174758346 | St Joseph Medical Center | Radiology | 407 E Vernon Ave, Normal, IL 61761-3813 | 2009-05-18 |
| 1659513711 | Junaid Pasha | Radiology | 407 E Vernon Ave, Normal, IL 61761-3813 | 2009-04-03 |
| 1306941760 | Saint Francis Medical Center | Radiology | 407 E Vernon Ave, Normal, IL 61761-3813 | 2006-09-13 |
| 1033172655 | Patrick S Fernandes | Radiology | 407 E Vernon Ave, Normal, IL 61761-3813 | 2006-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629690185 | Illinois Radiation Oncology Consultants Pllc | Radiology | 208 Flax Dr Ste 100, Highland, IL 62249-1396 | 2020-05-07 |
| 1770070609 | Brian Chou | Radiology | 2160 S 1st Ave Rm 2944, Maywood, IL 60153-3328 | 2018-04-17 |
| 1932606654 | Amishi Bajaj | Radiology | 2011 Midwest Club Pkwy, Oak Brook, IL 60523-2526 | 2018-04-09 |
| 1629502208 | Nathaniel Camden | Radiology | 500 South Paulina Street, Atrium Building, Ground Floor, Chicago, IL 60612-3833 | 2017-04-20 |
| 1811436553 | Seung Won Seol | Radiology | 251 E Huron St Ste Lc-178, Chicago, IL 60611 | 2017-02-14 |
| 1689051328 | Ross Scott Zeitlin | Radiology | 1901 W Harrison St Ste Ll-500, Chicago, IL 60612-3714 | 2015-05-01 |
| 1730578527 | Jeffrey Gross | Radiology | 6525 N Mozart St, Apt 3, Chicago, IL 60645-4377 | 2015-01-15 |
| 1508267220 | Vantage Cancer Care - Illinois, S.c. | Radiology | 17750 South Kedzie Avenue, Hazel Crest, IL 60429-2047 | 2014-09-12 |
| 1952714636 | Aditya Juloori | Radiology | 5841 S Maryland Ave # Mc9006, Chicago, IL 60637-1443 | 2014-06-10 |
| 1083047146 | Yoon Tae Kim | Radiology | 1025 Sunset Rd, Winnetka, IL 60093-3622 | 2013-08-13 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on COMMUNITY CANCER CENTER LLC.
| 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.