Active NPI
Illinois Cancer Specialists
- Community/Retail Pharmacy
- Niles, IL
National Provider Identifier
1649343864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 054014868
- Legal business name
- ILLINOIS CANCER SPECIALISTS
- Practice address
- 8915 W Golf Rd
Niles, IL 60714-5905 - Phone
- (847) 954-3480
- Fax
- (847) 827-1574
- NPI assigned
- Nov 16, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ria Dalmacio
- Title
- Network Contracting Representative
- Phone
- (312) 520-4757
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 054014868 | IL | Primary |
Addresses
Primary practice location
8915 W Golf Rd
Niles, IL 60714-5905
Mailing address
25070 Network PL
Chicago, IL 60673-1250
Phone (847) 585-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619809 | Other | IL | BLUECROSS BLUESHIELD IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930002641 | IL | DME Supplier - Multi-Specialty - Physician | 5597665752 |
1 other NPI on this enrollment Practice locations: Niles, IL |
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Hematology & Oncology Physician
- Niles, IL
- NPI 1164483913
O20100930002641
National Provider Directory
National Provider Directory- Tax ID family
- Northwest Medical Speci
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Hematology & Oncology Physician
- Chicago, IL
- NPI 1407331341
-
- Adult Health Nurse Practitioner
- Arlington Heights, IL
- NPI 1568836070
-
- Hematology & Oncology Physician
- Chicago, IL
- NPI 1750338844
Locations
3610 Paysphere Cir
#480
Chicago, IL 60674
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nurse Practitioner
- Arlington Heights, IL
- NPI 1629065099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1765152000000",
"number": "1649343864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25070 NETWORK PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606731250",
"telephone_number": "847-585-7000",
"fax_number": "847-240-0622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8915 W GOLF RD",
"city": "NILES",
"state": "IL",
"postal_code": "607145905",
"telephone_number": "847-954-3480",
"fax_number": "847-827-1574"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ILLINOIS CANCER SPECIALISTS",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-16",
"last_updated": "2025-12-08",
"certification_date": "2025-12-08",
"status": "A",
"authorized_official_last_name": "DALMACIO",
"authorized_official_first_name": "RIA",
"authorized_official_title_or_position": "NETWORK CONTRACTING REPRESENTATIVE",
"authorized_official_telephone_number": "312-520-4757"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "IL",
"license": "054014868",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD IL",
"identifier": "1619809",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Niles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.