NPIMap

Organization Active NPI

Oncology Hematology Associates of Central Il, PC

  • Community/Retail Pharmacy
  • Pekin, IL
National Provider Identifier
1518436757
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ONCOLOGY HEMATOLOGY ASSOCIATES OF CENTRAL IL, PC
Practice address
1641 Broadway St
Pekin, IL 61554-3805
Phone
(309) 243-3014
Fax
(309) 243-3032
NPI assigned
Nov 16, 2018
Organization subpart
Yes
Parent organization
ONCOLOGY HEMATOLOGY ASSOCIATES OF CENTRAL IL, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Authorized official

Name
Jason Harlow, PHARMD
Title
Director of Pharmacy
Phone
(309) 243-3403

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

1641 Broadway St
Pekin, IL 61554-3805

Mailing address

8940 N Wood Sage Rd
Peoria, IL 61615-7822
Phone (309) 243-3403

Other identifiers 1

IdentifierTypeStateIssuer
054020985OtherILSTATE LICENSE

Other names 1

  • Illinois CancerCare Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2147737Illinois Cancercare - Pekin1641 Broadway Street, Pekin, IL 61554ComplianceFeb 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
Oncology Hematology Associates of Central Illinois9 organizations share this tax ID, including this one
Part of
Oncology Hematology Associates of Central Illinois

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1641 Broadway St
Pekin, IL 61554
Phone (309) 243-3014

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1542326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542326400000",
    "number": "1518436757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8940 N WOOD SAGE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157822",
            "telephone_number": "309-243-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 BROADWAY ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615543805",
            "telephone_number": "309-243-3014",
            "fax_number": "309-243-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONCOLOGY HEMATOLOGY ASSOCIATES OF CENTRAL IL, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ONCOLOGY HEMATOLOGY ASSOCIATES OF CENTRAL IL, PC",
        "enumeration_date": "2018-11-16",
        "last_updated": "2018-11-16",
        "status": "A",
        "authorized_official_last_name": "HARLOW",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "309-243-3403",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "054020985",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Illinois CancerCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pekin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.