NPIMap

Organization Active NPI

Oncology Hematology Associates of Central Illinois

Doing business as Illinois Cancer Care

  • Community/Retail Pharmacy
  • Bloomington, IL
National Provider Identifier
1740662949
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054.019361 Issued in IL
Legal business name
ONCOLOGY HEMATOLOGY ASSOCIATES OF CENTRAL ILLINOIS
Doing business as
Illinois Cancer Care
Practice address
3105 Magory Drive
Bloomington, IL 61704
Phone
(309) 243-9018
Fax
(309) 243-3075
NPI assigned
Jun 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Authorized official

Name
Jason Harlow
Title
Pharmacist in Charge
Phone
(309) 243-3404

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 054.019361 IL Primary

Addresses

Primary practice location

3105 Magory Drive
Bloomington, IL 61704

Mailing address

3105 Magory Drive
Bloomington, IL 61704
Phone (309) 243-9018

Other identifiers 1

IdentifierTypeStateIssuer
2152589OtherPK

Other names 1

  • Illinois Cancer Care Doing business as

National Provider Directory

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

Other organizations with this tax ID 8

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

Locations

3105 Magory Dr
Bloomington, IL 61704
Phone (309) 243-9018

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435104000000",
    "number": "1740662949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 MAGORY DRIVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61704",
            "telephone_number": "309-243-9018",
            "fax_number": "309-243-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 MAGORY DRIVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61704",
            "telephone_number": "309-243-9018",
            "fax_number": "309-243-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONCOLOGY HEMATOLOGY ASSOCIATES OF CENTRAL ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-24",
        "last_updated": "2015-06-24",
        "status": "A",
        "authorized_official_last_name": "HARLOW",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "309-243-3404"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054.019361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2152589",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Illinois Cancer Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; 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.