Active NPI
Illinois Proton Center LLC
- Radiation Oncology Clinic/Center
- Warrenville, IL
National Provider Identifier
1972824142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Clinic/Center
- Legal business name
- ILLINOIS PROTON CENTER LLC
- Practice address
- 4455 Weaver Pkwy
Warrenville, IL 60555-3269 - Phone
- (630) 821-6400
- Fax
- (630) 821-6474
- NPI assigned
- Jun 22, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Mullen
- Title
- VP, Hospital Revenue Cycle, NMHC
- Phone
- (630) 938-6076
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Clinic/Center | 261QX0203X | Primary |
Addresses
Primary practice location
4455 Weaver Pkwy
Warrenville, IL 60555-3269
Mailing address
Dept 5777
Carol Stream, IL 60122
Other names 1
- Northwestern Medicine Chicago Proton Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101012000384 | IL | Part B Supplier - Radiation Therapy Center | 9436341286 |
Receives reassigned benefits from 18 practitioners Practice locations: Warrenville, IL |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- General Acute Care Hospital
- Winfield, IL
- NPI 1003864810
Member Of
Locations
4455 Weaver Pkwy
Warrenville, IL 60555
Phone (630) 821-6400
Practitioners & affiliated clinicians
Practitioners 18
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": "1277164800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1739318400000",
"number": "1972824142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DEPT 5777",
"city": "CAROL STREAM",
"state": "IL",
"postal_code": "60122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4455 WEAVER PKWY",
"city": "WARRENVILLE",
"state": "IL",
"postal_code": "605553269",
"telephone_number": "630-821-6400",
"fax_number": "630-821-6474"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ILLINOIS PROTON CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-06-22",
"last_updated": "2025-02-12",
"certification_date": "2025-02-12",
"status": "A",
"authorized_official_last_name": "MULLEN",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "VP, HOSPITAL REVENUE CYCLE, NMHC",
"authorized_official_telephone_number": "630-938-6076"
},
"taxonomies": [
{
"code": "261QX0203X",
"taxonomy_group": "",
"desc": "Clinic/Center, Oncology, Radiation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Northwestern Medicine Chicago Proton Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Warrenville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.