NPIMap

Organization Active NPI

Ausam Corp Chartered

  • Radiation Oncology Physician
  • Alton, IL
National Provider Identifier
1821110495
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
36117470 Issued in IL
Legal business name
AUSAM CORP CHARTERED
Practice address
6 Memorial Dr
Alton, IL 62002-6751
Phone
(618) 433-7979
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Authorized official

Name
Dr. Samuel Poriza Au, MD, PHD
Title
President
Phone
(618) 433-7979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X 36117470 IL Primary

Addresses

Primary practice location

6 Memorial Dr
Alton, IL 62002-6751

Mailing address

1 River Reach CT
Apt H
Alton, IL 62002-7387
Phone (618) 967-7275

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1821110495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RIVER REACH CT",
            "address_2": "APT H",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620027387",
            "telephone_number": "618-967-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 MEMORIAL DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026751",
            "telephone_number": "618-433-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSAM CORP CHARTERED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "AU",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "PORIZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-433-7979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "36117470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.