NPIMap

Organization Active NPI

University Hematology Oncology Group Inc.

  • Medical Oncology Physician
  • Centralia, IL
National Provider Identifier
1962698837
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
36-043159 Issued in IL
Legal business name
UNIVERSITY HEMATOLOGY ONCOLOGY GROUP INC.
Practice address
1052 Martin Luther King Dr
Suite 2
Centralia, IL 62801-3002
Phone
(314) 290-7501
Fax
(314) 290-7575
NPI assigned
Sep 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Raza M Syed, MBA
Title
Practice Administrator
Phone
(314) 290-7501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RX0202X 36-043159 IL Primary

Addresses

Primary practice location

1052 Martin Luther King Dr
Suite 2
Centralia, IL 62801-3002

Mailing address

4921 Parkview PL
Suite 14C
Saint Louis, MO 63110-1032
Phone (314) 290-7501

Other identifiers 1

IdentifierTypeStateIssuer
8221935OtherILBCBS IL

National Provider Directory

National Provider Directory

Locations

1052 Martin Luther King Dr
Ste 2
Centralia, IL 62801
Phone (618) 532-1807

13 Wolf Creek Dr
Ste 1
Swansea, IL 62226
Phone (314) 290-7501

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1962698837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "address_2": "SUITE 14C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-290-7501",
            "fax_number": "314-290-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1052 MARTIN LUTHER KING DR",
            "address_2": "SUITE 2",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013002",
            "telephone_number": "314-290-7501",
            "fax_number": "314-290-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY HEMATOLOGY ONCOLOGY GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "SYED",
        "authorized_official_first_name": "RAZA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "314-290-7501",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "IL",
            "license": "36-043159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL",
            "identifier": "8221935",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.