Provider Demographics
NPI:1033197207
Name:VALLEY CANCER CENTER
Entity Type:Organization
Organization Name:VALLEY CANCER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEELIMA
Authorized Official - Middle Name:D
Authorized Official - Last Name:KABRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-664-4141
Mailing Address - Street 1:PO BOX 15040
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-0040
Mailing Address - Country:US
Mailing Address - Phone:812-962-6413
Mailing Address - Fax:812-477-4153
Practice Address - Street 1:600 E 1ST ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:IL
Practice Address - Zip Code:61362
Practice Address - Country:US
Practice Address - Phone:815-664-4141
Practice Address - Fax:815-663-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-06
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCL1703OtherRR MEDICARE
ILCL1703OtherRR MEDICARE