MR. MARIO R VELASCO (NPI# 1326007782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326007782 |
| Entity Type | Individual |
| Full Name | MR. MARIO R VELASCO |
| Credential | MD |
| Practice Address |
210 W Mckinley Ave Suite 1 Decatur IL 62526 |
| Practice Telephone | 2178766600 |
| Practice Fax Number | 2178766606 |
| Mailing Telephone | 2178766600 |
| Mailing Fax Number | 2178766606 |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2014-02-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
036104082 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036104082 | 05 |
| Street Address |
210 W MCKINLEY AVE SUITE 1 |
| City | DECATUR |
| State | IL |
| Zip Code | 62526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871580142 | Cancer Care Specialists of Central Illinois, S.c. | Radiology | 210 W Mckinley Ave, Suite 1, Decatur, IL 62526-5858 | 2005-10-03 |
| 1538636642 | Jennifer Nicole Born | Nurse Practitioner | 210 W Mckinley Ave, Decatur, IL 62526-5858 | 2018-10-26 |
| 1356874093 | Cancer Care Specialists of Central Illinois, S.c | Pharmacy | 210 W Mckinley Ave, Suite 6, Decatur, IL 62526-5858 | 2017-04-10 |
| 1720510878 | Kristin Lafollette | Pharmacist | 210 W Mckinley Ave, Suite 6, Decatur, IL 62526-5858 | 2017-03-29 |
| 1689886962 | Evelena Ontiveros | Internal Medicine | 210 W Mckinley Ave, Ste 1, Decatur, IL 62526-5858 | 2007-05-07 |
| 1689761223 | Prairie Oncology Management Services Pharmacy | Pharmacist | 210 W Mckinley Ave, Ste 1, Decatur, IL 62526-5858 | 2006-10-06 |
| 1396701009 | Sebastien Simon Kairouz | Internal Medicine | 210 W Mckinley Ave, Suite 1, Decatur, IL 62526-5858 | 2006-04-21 |
| 1932168309 | Perry P Guaglianone | Internal Medicine | 210 W Mckinley Ave, Suite 1, Decatur, IL 62526 | 2006-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 207RX0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Medical Oncology |
| An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023025434 | Naveen Thomas Lobo | Internal Medicine | 1310 14th Ave Se, Decatur, AL 35601-4347 | 2006-08-01 |
| 1992774459 | James L Wade IIi | Internal Medicine | 210 W. Mckinley Ave, Ste 1, Decatur, IL 62526 | 2006-03-16 |
| 1861797920 | Cancer Care Center PC | Internal Medicine | 1310 14th Ave Se, Decatur, AL 35601-4347 | 2011-01-21 |
| 1720200504 | Haig Yardumian | Internal Medicine | 150 E Ponce De Leon Ave, Suite 120, Decatur, GA 30030-2543 | 2007-05-02 |
| 1801911334 | Hagop Youssoufian | Internal Medicine | 150 E Ponce De Leon Ave, Suite 120, Decatur, GA 30030-2543 | 2007-03-21 |
| 1245309541 | Emiliana Sandiego | Internal Medicine | 150 E Ponce De Leon Ave, Suite 220, Decatur, GA 30030-2543 | 2006-11-08 |
| 1073604245 | Zeba Aziz | Internal Medicine | 150 E Ponce De Leon Ave, Suite 220, Decatur, GA 30030-2543 | 2006-09-27 |
| 1790748119 | Edward C Elliott II | Internal Medicine | 210 W. Mckinley Ave, Ste 1, Decatur, IL 62526 | 2006-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831647205 | Marcelo Rocha De Sousa Cruz | Internal Medicine | 233 East Superior Street, 1st Floor, Chicago, IL 60611 | 2016-09-14 |
| 1720426513 | Michael John Jelinek | Internal Medicine | 1725 W Harrison St Ste 809, Chicago, IL 60612-3861 | 2013-06-13 |
| 1265696348 | Sunandana Chandra | Internal Medicine | 645 N. Michigan Avenue, Suite 1006, Chicago, IL 60611 | 2008-07-17 |
| 1033318043 | John Charles Brooks | Internal Medicine | 753 Brookwood Ter # 5, Olympia Fields, IL 60461-1543 | 2007-07-11 |
| 1598819575 | Sabet Siddiqui | Internal Medicine | 9 Health Services Dr Ste 5, Dekalb, IL 60115-9601 | 2007-01-23 |
| 1417011529 | Alicia Katherine Morgans | Internal Medicine | 676 N Saint Clair St Fl 21, Chicago, IL 60611-2927 | 2006-12-21 |
| 1629166442 | Matthew Eric Adess | Internal Medicine | 757 Park Ave W, Highland Park, IL 60035-2556 | 2006-10-10 |
| 1629164678 | Justin D Floyd | Internal Medicine | 13 Wolf Creek Dr, Suite 1, Swansea, IL 62226-2367 | 2006-10-05 |
| 1356441943 | Osvaldo H Wesly | Internal Medicine | 105 S. Amos Ave, Springfield, IL 62704 | 2006-09-23 |
| 1467467803 | Mid-illinois Hematology Oncology Associates Ltd | Internal Medicine | 407 E Vernon Ave Ste 104, Normal, IL 61761-3813 | 2006-07-31 |
| Find all providers with the same taxonomy | ||||
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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.