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Contact Information

VANTAGE CANCER CARE - ILLINOIS, S.C.
17750 SOUTH KEDZIE AVENUE
HAZEL CREST, IL60429-2047
 Phone: 708-799-9995
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical Oncology

207RX0202X 11 Physician/Internal Medicine
 

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
Indicates primary specialty

NPI Profile & details for VANTAGE CANCER CARE - ILLINOIS, S.C.

NPI Number 1508267220
LBN Legal business name VANTAGE CANCER CARE - ILLINOIS, S.C.
Authorized official LESLIE BOTNIK - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/12/2014
Last updated 09/15/2014 - About 12 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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