MEDONC LTD (NPI# 1346427911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346427911 |
| Entity Type | Organization |
| Organization Name | MEDONC LTD |
| Practice Address |
3703 Ballantrae Way Flossmoor IL 60422-4316 |
| Practice Telephone | 7089556415 |
| Mailing Telephone | 7089556415 |
| Enumeration Date | 2008-01-26 |
| Last Update Date | 2008-01-26 |
| Authorized Official Name | AYOOLA SAMUEL AWOFADEJU (PRESIDENT/CEO) |
| Authorized Official Telephone | 7089556415 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | DC3459 | 01 |
| Street Address |
3703 BALLANTRAE WAY |
| City | FLOSSMOOR |
| State | IL |
| Zip Code | 60422-4316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760423461 | Ayoola Samuel Awofadeju | Emergency Medicine | 3703 Ballantrae Way, Flossmoor, IL 60422-4316 | 2006-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588274310 | Miranda Home Health Care Inc | Nursing Care | 19150 S. Kedzie Ave, 203, Flossmoor, IL 60422 | 2020-08-06 |
| 1285256172 | Bp Behavioral Services, LLC | Behavioral Analyst | 2222 Marston Lane, Flossmoor, IL 60422 | 2020-05-13 |
| 1891164133 | Lauren Simpson | Behavioral Analyst | 19530 Kezie Avenue, Flossmoor, IL 60422 | 2015-09-16 |
| 1437541190 | Keshawn Gardner | Specialist/Technologist, Other | 1248 Berry Ln, Flossmoor, IL 60422 | 2015-03-04 |
| 1770989717 | Naomi Kelly | Behavioral Analyst | 1930 Kedzie Avenue, Flossmoor, IL 60422 | 2014-11-18 |
| 1093059453 | Miranda Home Health Care Inc | In Home Supportive Care | 19150 S Kedzie Ave, 203, Flossmoor, IL 60422 | 2012-11-23 |
| 1285981506 | Restorative Life Services, LLC | Social Worker | 169624 Governors Highway, Flossmoor, IL 60422 | 2012-08-06 |
| 1063786457 | Gwyneeda Carter-sidberry | Pharmacist | 1443 Selkirk Street, Flossmoor, IL 60422 | 2012-03-02 |
| 1053682021 | Alfonso Javier Medina Sr. | Anesthesiology | 3141 Stonegate Ct., Flossmoor, IL 60422 | 2012-01-23 |
| 1912121161 | Anthony J Maoloni | Dentist | 19815 Governors Highway, Orthodontic Associates Ltd Suite 1, Flossmoor, IL 60422 | 2007-04-12 |
| Find all providers in zip 60422 | ||||
| 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 |
|---|---|---|---|---|
| 1477629491 | John Thomas Smallwood | Internal Medicine | 2448 Brookwood Dr, Flossmoor, IL 60422-1826 | 2006-11-28 |
| 1346569563 | Kimberly R Kruczek | Internal Medicine | 19550 Governors Hwy, Suite 3300, Flossmoor, IL 60422-2125 | 2010-05-27 |
| 1023243748 | Danielle Renee Sterrenberg | Internal Medicine | 19550 Governors Hwy, Suite 3300, Flossmoor, IL 60422-2125 | 2009-05-26 |
| 1184819856 | Lekha Babu Md Ltd | Internal Medicine | 3235 Vollmer Road, Flossmoor, IL 60422 | 2007-09-06 |
| 1174678684 | Patrick L Mcginnis | Internal Medicine | 3235 Vollmer Rd, Suite 120, Flossmoor, IL 60422-2013 | 2007-01-24 |
| 1740384023 | Lekha Babu | Internal Medicine | 3235 Vollmer Rd, Ste 126, Flossmoor, IL 60422 | 2006-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649831124 | Elena Vagia | Internal Medicine | 233 E Superior St Ste 1-061, Chicago, IL 60611-2913 | 2019-06-25 |
| 1194206367 | Illinois Cancer Specialists | Internal Medicine | 360 Station Dr Ste 201, Crystal Lake, IL 60014-7978 | 2018-08-27 |
| 1861986549 | Quincy Physicians & Surgeons Clinic, Sc | Internal Medicine | 3347 Broadway St, Quincy, IL 62301 | 2018-06-18 |
| 1730634700 | Liyun Huang | Internal Medicine | 17495 South La Grange Rd, Tinley Park, IL 60487 | 2016-08-19 |
| 1578017596 | Mercy Clinic Specialists Services-illinois LLC | Internal Medicine | 2227 Vadalabene Dr Ste 200, Maryville, IL 62062-5824 | 2016-08-08 |
| 1356793319 | Glenda Maria Delgado Ramos | Internal Medicine | 2160 S 1st Ave Ste 167, Maywood, IL 60153-3328 | 2016-07-01 |
| 1023403516 | Meghan Rebecca Steiner | Internal Medicine | 5841 S Maryland Ave # Mc-2115, Chicago, IL 60637 | 2015-04-01 |
| 1700270154 | Joseph Heng | Internal Medicine | 5841 S Maryland Ave # Mc1152, Chicago, IL 60637-1443 | 2015-03-24 |
| 1497148118 | Pinal Chokshi | Internal Medicine | 525 E Congress Pkwy Ste 300, Crystal Lake, IL 60014-6258 | 2015-03-05 |
| 1770998262 | Adventist Bolingbrook Hospital | Internal Medicine | 420 S Schmidt, Ste 230, Bolingbrook, IL 60440 | 2014-06-24 |
| 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.