SOUTHERN COOK RADIATION ONCOLOGY LTD NPI 1487635314

NPI Information

  • NPI: 1487635314
  • Provider Name: SOUTHERN COOK RADIATION ONCOLOGY LTD
  • Classification: Radiology - 2085R0001X
  • Specialization: Radiation Oncology
  • Entity Type: Organization
  • Address: 2310 YORK ST
    SUITE M
    BLUE ISLAND, IL
    ZIP 60406
  • Phone: (708) 396-0910

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NPI Details

SOUTHERN COOK RADIATION ONCOLOGY LTD is a radiation oncology radiology in Blue Island, 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. SOUTHERN COOK RADIATION ONCOLOGY LTD NPI is 1487635314. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2310 YORK ST
SUITE M
BLUE ISLAND, IL
ZIP 60406-411
Phone: (708) 396-0910
Fax: (708) 388-4354

The provider's authorized official is Gregorio M Tolentino .
The authorized official title is Officer and has the following contact phone number (708) 396-0910.

The enumeration date for this NPI number is 11/8/2005 and was last updated on 7/23/2010.

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

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1211514MEDICARE PIN
21617459OTHERILLINOISBCBS IL GR #
3CL9637OTHERRR MEDICARE GR

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: 3/30/2025

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