Intercommunity Cancer Center Of Western Illinois
LBN: Western Illinois Cancer Treatment Center
Intercommunity Cancer Center Of Western Illinois is an health care organization with primary practice located at 450 Mayo Dr , Galesburg IL 61401-1211. The organization recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Radiation Therapy, which is considered as the primary health care specialty.
Western Illinois Cancer Treatment Center can be contacted via phone (309) 344-2831, or through Wilkins, Warren M via phone (309) 344-2831.
Contact Information
Primary practice address
450 Mayo Dr
Galesburg IL 61401-1211
Phone: (309) 344-2831
Fax: (309) 344-2014
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Technologists, Technicians & Other Technical Service Providers / Radiation Therapy | 2471R0002X | 036077270 | Illinois |
Profile Details
| NPI number | 1417985011 |
|---|---|
| LBN Legal business name | Western Illinois Cancer Treatment Center |
| DBA Doing business as | Intercommunity Cancer Center Of Western Illinois |
| Authorized official | Wilkins, Warren M Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 30th, 2006 |
| Last updated | Apr 30th, 2008 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417985011 | NPPES |
| Other | 007799 | HEALTH ALLIANCE | |
| Other | 014885 | HEALTH ALLIANCE | |
| Other | 04815059 | HEALTH ALLIANCE | |
| Other | CM5868 | HEALTH ALLIANCE |
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