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KANKAKEE RADIATION ONCOLOGY LLC NPI 1740477900


NPI Information

NPI: 1740477900
Provider Name: KANKAKEE RADIATION ONCOLOGY LLC
Classification: Radiology - 2085R0001X
Entity Type: Organization

Specialization: Radiation Oncology

Address:
100 PROVENA WAY
SUITE 102
BOURBONNAIS, IL
ZIP 60914
Phone: (815) 937-2460
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KANKAKEE RADIATION ONCOLOGY LLC is a radiation oncology radiology in Bourbonnais, IL. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. KANKAKEE RADIATION ONCOLOGY LLC NPI is 1740477900. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

100 PROVENA WAY
SUITE 102
BOURBONNAIS, IL
ZIP 60914-796
Phone: (815) 937-2460
Fax: (815) 937-2031

The provider's authorized official is Robert T Woodburn .
The authorized official title is Officer and has the following contact phone number (708) 460-9836.

The enumeration date for this NPI number is 10/1/2007 and was last updated on 10/1/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0001XRadiologyRadiation OncologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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