Illinois Regional Cancer Center LLP

Primary specialty

SpecialistTaxonomy code 174400000X

License

036-061312 Issued in IL

Legal business name

ILLINOIS REGIONAL CANCER CENTER LLP

Practice address

10 Health Services Dr
Dekalb, IL 60115-9637

Phone

(815) 756-4722

Fax

(815) 756-4046

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Bharati D. Bhate, MD

Title

Medical Director

Phone

(815) 756-4722

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438732800000",
    "number": "1760524995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 723",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601150723",
            "telephone_number": "815-756-4722",
            "fax_number": "815-756-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HEALTH SERVICES DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159637",
            "telephone_number": "815-756-4722",
            "fax_number": "815-756-4046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS REGIONAL CANCER CENTER LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2015-08-05",
        "status": "A",
        "authorized_official_last_name": "BHATE",
        "authorized_official_first_name": "BHARATI",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "815-756-4722",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-061312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NPI NUMBER",
            "identifier": "1962496034",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-061312",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Dekalb, IL
• Providers in Dekalb, IL by specialty
• Specialist in Illinois

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