NORTHERN ILLINOIS CANCER TREATMENT CENTER (NPI# 1386644995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386644995 |
| Entity Type | Organization |
| Organization Name | NORTHERN ILLINOIS CANCER TREATMENT CENTER |
| Practice Address |
327 Il Route 2 Dixon IL 61021-9118 |
| Practice Telephone | 8152841111 |
| Practice Fax Number | 8152842306 |
| Mailing Telephone | 8152841111 |
| Mailing Fax Number | 8152842306 |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | THERESA FREIL-DRAPER (PRESIDENT) |
| Authorized Official Telephone | 8156250400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2471R0002X |
Radiologic Technologist Specialization: Radiation Therapy |
Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE SHIELD PROVIDER NUMB | 05215222 | 01 |
| Street Address |
327 IL ROUTE 2 |
| City | DIXON |
| State | IL |
| Zip Code | 61021-9118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396284717 | Saleh Hatoum | Radiology | 327 Il Route 2, Dixon, IL 61021-9118 | 2017-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699331082 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1600 South Galena Ave, Dixon, IL 61021 | 2019-05-12 |
| 1285135590 | Richard Allen Sibert | Counselor | 325 Il Route 2,dixon Il, Dixon, IL 61021 | 2018-02-22 |
| 1518485432 | Madeline Luniewicz | Counselor | 325 Il-2, Dixon, IL 61021 | 2017-08-30 |
| 1669992566 | Nicole Marie Shaffer | Specialist/Technologist | 650 Reynoldswood Road, Dixon, IL 61021 | 2017-06-21 |
| 1346660446 | Lydia Sitter | Audiologist | 215 3. 1st Street, Suite 317, Ksb Medical Group, Dixon, IL 61021 | 2014-04-16 |
| 1053600080 | Janet I. Malmberg | Nurse Practitioner | 309 South Galena Ave, Suite 100, Dixon, IL 61021 | 2011-03-30 |
| 1376775262 | Kelly L Klein | Optometrist | 511 Palmyra Street, Ksb Eye & Vision Care, Dixon, IL 61021 | 2009-08-11 |
| 1013119106 | Michael Joseph Sarno | Physical Therapist | 401 E. First Street, Dixon, IL 61021 | 2007-06-01 |
| 1891905600 | Thomas G. Gehlbach | Internal Medicine | 215 E 1st St Ste 111, Dixon, IL 61021 | 2007-05-23 |
| 1699987230 | Sameer Jain | Family Medicine | 102 S. Hennepin Ave., Ksb Medical Group, Dixon, IL 61021 | 2007-05-04 |
| Find all providers in zip 61021 | ||||
| Taxonomy Code | 2471R0002X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Radiation Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598135063 | Joshua Mccann | Radiologic Technologist | 386 Rohlfing Rd, Campbell Hill, IL 62916-2410 | 2015-09-28 |
| 1417985011 | Western Illinois Cancer Treatment Center | Radiologic Technologist | 450 Mayo Dr, Galesburg, IL 61401-1211 | 2006-06-30 |
| 1679196125 | Jarrod Alan Walters | Radiologic Technologist | 4455 Weaver Pkwy, Warrenville, IL 60555-3269 | 2020-05-19 |
Please comment or provide details below to improve the information on NORTHERN ILLINOIS CANCER TREATMENT CENTER.
| 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.