NPIMap

Organization Active NPI

Illinois Proton Center LLC

Doing business as Northwestern Medicine Chicago Proton Center

  • Radiation Oncology Clinic/Center
  • Warrenville, IL
National Provider Identifier
1972824142
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology Clinic/CenterTaxonomy code 261QX0203X
Legal business name
ILLINOIS PROTON CENTER LLC
Doing business as
Northwestern Medicine Chicago Proton Center
Practice address
4455 Weaver Pkwy
Warrenville, IL 60555-3269
Phone
(630) 821-6400
Fax
(630) 821-6474
NPI assigned
Jun 22, 2010
Last updated
Feb 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101012000384 IL Part B Supplier - Radiation Therapy Center 9436341286 Receives reassigned benefits from 18 practitioners
Practice locations: Warrenville, IL

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

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.

Verify at the official NPI Registry.