Kankakee Radiation Oncology LLC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

KANKAKEE RADIATION ONCOLOGY LLC

Practice address

100 Provena Way
Suite 102
Bourbonnais, IL 60914-4796

Phone

(815) 937-2460

Fax

(815) 937-2031

NPI assigned

Oct 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert T Woodburn, MD

Title

Officer

Phone

(708) 460-9836

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1740477900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 379",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604620379",
            "telephone_number": "708-460-9836",
            "fax_number": "708-460-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PROVENA WAY",
            "address_2": "SUITE 102",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609144796",
            "telephone_number": "815-937-2460",
            "fax_number": "815-937-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANKAKEE RADIATION ONCOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "WOODBURN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "708-460-9836",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie M Leidecker LTD (A Step Ahead Pediatric Therapy)
• Snigdha Kalidindi
• Elizabeth Kalwinski
• Carly Kaminke, PA-C
• Brandi Kaye Kaner
• Kankakee Terrace Operator LLC
• Kankakee Valley Oral Maxillofacial Surgery PC
• Matthew Kaplan, DO
• Craig T Karvala, D.C.
• Katelyn Dircks

• Radiation Oncology Physician in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Radiation Oncology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.