NPIMap

Organization Active NPI

Northwest Indiana Radiation Oncology, PC

  • Specialist
  • Crown Point, IN
National Provider Identifier
1487684395
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
IN01030584A Issued in IN
Legal business name
NORTHWEST INDIANA RADIATION ONCOLOGY, PC
Practice address
1201 Main St
Crown Point, IN 46307-2716
Phone
(708) 482-4949
Fax
(708) 482-4949
NPI assigned
Jul 4, 2006
Last updated
Jan 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Abdul Waheed Khan, MDNPI 1679509442
Title
Vice-President
Phone
(219) 757-6285

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IN01030584A IN Primary

Addresses

Primary practice location

1201 Main St
Crown Point, IN 46307-2716

Mailing address

PO Box 226
Olympia Fields, IL 60461-0226
Phone (708) 482-4949

Other identifiers 1

IdentifierTypeStateIssuer
100188320AMedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1487684395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 226",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604610226",
            "telephone_number": "708-482-4949",
            "fax_number": "708-482-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 MAIN ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463072716",
            "telephone_number": "708-482-4949",
            "fax_number": "708-482-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST INDIANA RADIATION ONCOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_middle_name": "WAHEED",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "219-757-6285",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "IN01030584A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100188320A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.