UNIVERSITY HEMATOLOGY ONCOLOGY GROUP INC. (NPI# 1962698837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962698837 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY HEMATOLOGY ONCOLOGY GROUP INC. |
| Practice Address |
1052 Martin Luther King Dr Suite 2 Centralia IL 62801-3002 |
| Mailing Address |
4921 Parkview Pl Suite 14c Saint Louis MO 63110-1032 |
| Practice Telephone | 3142907501 |
| Practice Fax Number | 3142907575 |
| Mailing Telephone | 3142907501 |
| Mailing Fax Number | 3142907575 |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2008-02-19 |
| Authorized Official Name | RAZA M SYED (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 3142907501 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
36-043159 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS IL | 8221935 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275729550 | University Hematology Oncology Group Inc. | Internal Medicine | 2210 Barron Rd, Suite 117, Poplar Bluff, MO 63901-1908 | 2007-09-19 |
| Street Address |
1052 MARTIN LUTHER KING DR SUITE 2 |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62801-3002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942301940 | James E Hays | Specialist | 1052 Martin Luther King Dr, Centralia, IL 62801 | 2006-09-25 |
| 1023293776 | University Hematology Oncology Inc | Clinic/Center | 1052 Martin Luther King Dr, Suite 2, Centralia, IL 62801-3002 | 2007-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1629573365 | Prabhat Shrestha | Student in an Organized Health Care Education/Training Program | 605 Sable Drive, Centralia, IL 62801 | 2018-03-26 |
| 1619496098 | Whitney Rathmann | Speech-Language Pathologist | 224 South Locust, Centralia, IL 62801 | 2017-09-17 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| 1568820637 | Midland Area Agency On Aging | Case Management | 434 S Poplar Street, Centralia, IL 62801 | 2016-02-04 |
| 1104201714 | Keri Douglas | Nurse Practitioner | 1054 M. L. King Drive #125, Centrailia, IL 62801 | 2015-07-24 |
| 1215331509 | Melissa Dane | Counselor | 904 E Martin Luther King Dr., Centralia, IL 62801 | 2014-10-15 |
| Find all providers in zip 62801 | ||||
| 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 |
|---|---|---|---|---|
| 1003009259 | Providence Health & Service - Washington | Internal Medicine | 2015 Cooks Hill Rd, Suite 200, Centralia, WA 98531-9074 | 2007-08-21 |
| 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.