Vantage Cancer Care - Illinois, S.C.

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

Legal business name

VANTAGE CANCER CARE - ILLINOIS, S.C.

Practice address

17750 South Kedzie Avenue
Hazel Crest, IL 60429-2047

Phone

(708) 799-9995

NPI assigned

Sep 12, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Leslie E. Botnik, M.D.

Title

President

Phone

(323) 595-5769

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410739200000",
    "number": "1508267220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ROSECRANS AVENUE",
            "address_2": "SUITE 400",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663707",
            "telephone_number": "310-335-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17750 SOUTH KEDZIE AVENUE",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292047",
            "telephone_number": "708-799-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANTAGE CANCER CARE - ILLINOIS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-12",
        "last_updated": "2014-09-15",
        "status": "A",
        "authorized_official_last_name": "BOTNIK",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-595-5769",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• United Mental Health Organization of Illinois
• United Pain Services SC
• United Pain Surgicore SC
• Universal Medical Products
• Charles M Van Slambrouck, MD
• Vantage Cancer Care Network of Illinois, S.C.
• Varsha Bhan MD SC
• Vascular Surgery and Interpretation S.C.
• Vertical Plus MRI of America, LLC
• Vertical Plus of Hazel Crest

• Medical Oncology Physician in Hazel Crest, IL
• Providers in Hazel Crest, IL by specialty
• Medical Oncology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; 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.