Canyon Crest Radiation Oncology PLLC

Organization Active NPI Radiation Oncology Physician · Peru, IL

NPI 1316869746 · NPPES record last updated Jul 28, 2026

Key facts

NPI
1316869746
Entity type
Organization (NPI type 2)
Primary specialty
Radiation Oncology Physician 2085R0001X
Legal business name
CANYON CREST RADIATION ONCOLOGY PLLC
Practice address
4931 Venture Drive
Peru, IL 61345
Phone
(779) 345-2945
NPI assigned
Jul 28, 2026
Organization subpart
No

Authorized official

Name
Dr. Robert Theodore Woodburn III, MD
Title
Authorized Official
Phone
(219) 741-1713

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
2085R0001X Yes

Addresses

Primary practice location

4931 Venture Drive
Peru, IL 61345

Mailing address

4931 Venture Drive
Peru, IL 61345

Other providers in Peru, IL

All providers in Peru, IL · Radiation Oncology Physician in Illinois

Sources for this page

Verify at the official NPI Registry.