MT VERNON RADIATION THERAPY CENTER


Address: 4117 Veterans Memorial Dr, Mount Vernon, IL 62864-6262
Phone: 6182411827

MT VERNON RADIATION THERAPY CENTER (NPI# 1952477028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952477028
Entity Type Organization
Organization Name MT VERNON RADIATION THERAPY CENTER
Practice Address 4117 Veterans Memorial Dr
Mount Vernon
IL 62864-6262
Mailing Address Po Box 504229
Saint Louis
MO 63150-0001
Practice Telephone 6182411827
Mailing Telephone 6182411827
Enumeration Date 2006-11-28
Last Update Date 2009-10-05
Authorized Official Name MR. RICHARD HUNTINGTON (VICE PRESIDENT BUSINESS DEVELOPMENT)
Authorized Official Telephone 6182412204
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QX0203X Clinic/Center
Specialization: Oncology, Radiation
========= IL Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
IL GROUP HEALTH PLAN 276923 01
IL BLUE CROSS BLUE SHIELD 4132037 01

Office Location

Street Address 4117 VETERANS MEMORIAL DR
City MOUNT VERNON
State IL
Zip Code 62864-6262

Providers in the same location

NPI Name Taxonomy Address Enumeration
1912984766 Yagnesh V. Oza Internal Medicine 4117 Veterans Memorial Dr, Mount Vernon, IL 62864-6262 2005-12-22
1740582246 Avani Changela Internal Medicine 4117 Veterans Memorial Dr, Mount Vernon, IL 62864-6262 2010-12-03
1407004773 Kathleen Marie Naegele Internal Medicine 4117 Veterans Memorial Dr, Mount Vernon, IL 62864-6262 2008-08-28
1316000219 Gloria Nicole Abenes Nurse Practitioner 4117 Veterans Memorial Dr, Mount Vernon, IL 62864-6262 2006-12-19
1053364885 Oza Oncology Inc. Radiology 4117 Veterans Memorial Dr, Mount Vernon, IL 62864-6262 2006-05-19

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1619438892 Melissa Pryer Dietitian, Registered 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 2019-03-28
1487145454 Chiropractic Wellness Center of Mt Vernon, LLC. Chiropractor 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 2018-05-24
1851889208 Kimberly Tate Counselor 4110 North Water Place, Mt. Vernon, IL 62864 2018-05-01
1871907790 University Hematology Oncology Inc Specialist #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 2014-06-18
1457771677 Dynamic Counseling and Consultation Services Social Worker 3600 S Water Tower Pl, Mt Vernon, IL 62864 2014-04-27
1619239431 Judith C Morgan Counselor 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 2012-06-08
1073888624 James Brian Verges Counselor 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 2012-03-15
1720352271 Lucinda M. Holdren Counselor 16338 North Illinois Highway 37, Mount Vernon, IL 62864 2012-03-01
1780978627 Jamie M Orange Physical Therapy Assistant 19958 Fairfield Rd, Mt. Vernon, IL 62864 2011-06-08
1780978791 Wendy Marie Claytor Speech-Language Pathologist 600 E Il Hwy 15, Mount Vernon, IL 62864 2011-06-07
Find all providers in zip 62864

Taxonomy Information

Taxonomy Code 261QX0203X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Oncology, Radiation

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1194220897 South Campus Partners, Inc. Clinic/Center 15300 West Ave Bldg A, Orland Park, IL 60462-4600 2018-03-26
1316202344 Skan LLC Clinic/Center 3425 Drew Avenue, Suite A, Sandwich, IL 60548-2351 2012-07-05
1144327487 Northern Illinois University Clinic/Center Kirk and Pine Rd, Batavia, IL 60510 2006-09-20
1134233950 Bharat S Jailwala Clinic/Center 846 Dundee Ave, Elgin, IL 60120-3068 2006-08-18
1407818644 Freeport Regional Health Care Services Clinic/Center 1163 W Stephenson St, Freeport, IL 61032-4866 2006-04-04
1497314462 Highland Oncology, Ltd Clinic/Center 208 Flax Dr, Highland, IL 62249-1375 2019-06-12
1972824142 Illinois Proton Center LLC Clinic/Center 4455 Weaver Pkwy, Warrenville, IL 60555-3269 2010-06-22
1750401196 American Cancer Center Clinic/Center 846 Dundee Ave, Elgin, IL 60120-3068 2007-03-30
1720185150 Morris Hospital Clinic/Center 1600 W Us Route 6, Morris, IL 60450 2006-09-20

Competitor

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City MOUNT VERNON
Zip Code 62864

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Dataset Information

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.

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