Advanced Cancer Clinic LTD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

036083034 Issued in IL

Legal business name

ADVANCED CANCER CLINIC LTD

Practice address

2222 W Division St
#215
Chicago, IL 60622-2717

Phone

(773) 227-8807

Fax

(773) 227-8907

NPI assigned

Sep 1, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Maciej K Drazkiewicz, MDNPI 1497708333

Title

Director/President

Phone

(773) 227-8807

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Maciej Drazkiewicz, M.D. Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maciej K Drazkiewicz, MD

  • Hematology & Oncology Physician
  • Chicago, IL
  • NPI 1497708333
  Medicare reassignment NPD Authorized official
• Amir Islam Khan, PA

  • Medical Physician Assistant
  • Chicago, IL
  • NPI 1316207111
  NPD (past)

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366675200000",
    "number": "1790779023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 W DIVISION ST",
            "address_2": "#215",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222717",
            "telephone_number": "773-227-8807",
            "fax_number": "773-227-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 W DIVISION ST",
            "address_2": "#215",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222717",
            "telephone_number": "773-227-8807",
            "fax_number": "773-227-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CANCER CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-01",
        "last_updated": "2013-04-23",
        "status": "A",
        "authorized_official_last_name": "DRAZKIEWICZ",
        "authorized_official_first_name": "MACIEJ",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DIRECTOR/PRESIDENT",
        "authorized_official_telephone_number": "773-227-8807",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036083034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036083034",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI ENUMERATOR",
            "identifier": "1497708333",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maciej Drazkiewicz, M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Hematology & Oncology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Hematology & Oncology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.

Verify at the official NPI Registry.