VANTAGE CANCER CARE - ILLINOIS, S.C. (NPI# 1508267220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508267220 |
| Entity Type | Organization |
| Organization Name | VANTAGE CANCER CARE - ILLINOIS, S.C. |
| Practice Address |
17750 South Kedzie Avenue Hazel Crest IL 60429-2047 |
| Mailing Address |
1500 Rosecrans Avenue Suite 400 Manhattan Beach CA 90266-3707 |
| Practice Telephone | 7087999995 |
| Mailing Telephone | 3103354000 |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2014-09-15 |
| Authorized Official Name | DR. LESLIE E. BOTNIK (PRESIDENT) |
| Authorized Official Telephone | 3235955769 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians |
| Street Address |
17750 SOUTH KEDZIE AVENUE |
| City | HAZEL CREST |
| State | IL |
| Zip Code | 60429-2047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235530957 | Vantage Cancer Care Network of Illinois, S.c. | Radiology | 17750 South Kedzie Avenue, Hazel Crest, IL 60429-2047 | 2014-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659917987 | Nancy Sinwelski | Technician | 17305 Fisk Street, East Hazelcrest, IL 60429 | 2019-11-21 |
| 1144720871 | Plentiful Hair Studio LLC | Specialist | 17504 E Carriageway Dr Ste D, Hazel Crest, IL 60429 | 2018-02-19 |
| 1376052142 | Natalie Allen | Counselor | 3518 Birchwood Dr, Hazel Crest, IL 60429 | 2017-09-25 |
| 1730534009 | Lydena Franklin | Counselor | 1909 Cheker Square, East Hazel Crest, IL 60429 | 2016-04-25 |
| 1710331053 | Lauiren Orta | Counselor | 1901 Cheker Square, E Hazel Crest, IL 60429 | 2016-04-22 |
| 1427423367 | Andrea Leigh Warren | Nurse Practitioner | 17800 S. Kedzie Ave, Hazel Crest, IL 60429 | 2015-12-03 |
| 1770969354 | Karriem's Developmental Services | Day Training, Developmentally Disabled Services | 18513 River Road, Hazel Crest, IL 60429 | 2015-08-05 |
| 1073905170 | James Kamper | Physical Therapy Assistant | 1816 W 170th Street, Hazel Crest, IL 60429 | 2015-02-26 |
| 1194066019 | Marilyn C Scott | Psychologist | 18505 Meadow Ln., Hazel Crest, IL 60429 | 2013-03-04 |
| 1649548405 | Supported Independence | Community/Behavioral Health | 17009 Elm Drive, Hazel Crest, IL 60429 | 2011-12-08 |
| Find all providers in zip 60429 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
| City | HAZEL CREST |
| Zip Code | 60429 |
Please comment or provide details below to improve the information on VANTAGE CANCER CARE - ILLINOIS, S.C..
| 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.