NPIMap

Organization Active NPI

Illinois Radiation Oncology Consultants PLLC

  • Radiation Oncology Physician
  • Highland, IL
National Provider Identifier
1629690185
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
ILLINOIS RADIATION ONCOLOGY CONSULTANTS PLLC
Practice address
208 Flax Dr Ste 100
Highland, IL 62249-1396
Phone
(618) 882-5621
NPI assigned
May 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Authorized official

Name
Jacqueline Mudd
Title
Administrator
Phone
(217) 324-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

208 Flax Dr Ste 100
Highland, IL 62249-1396

Mailing address

PO Box 483
Litchfield, IL 62056-0483
Phone (217) 324-1100

National Provider Directory

National Provider Directory

Locations

208 Flax Dr
Ste 100
Highland, IL 62249
Phone (618) 882-5621

NPI Registry JSON

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1629690185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 483",
            "city": "LITCHFIELD",
            "state": "IL",
            "postal_code": "620560483",
            "telephone_number": "217-324-1100",
            "fax_number": "217-324-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 FLAX DR STE 100",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491396",
            "telephone_number": "618-882-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS RADIATION ONCOLOGY CONSULTANTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-07",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "MUDD",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "217-324-1100"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.