Provider Demographics
NPI:1275128282
Name:RJ IR VASCULAR AND ONCOLOGY CENTER PLLC
Entity Type:Organization
Organization Name:RJ IR VASCULAR AND ONCOLOGY CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROTIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-927-5665
Mailing Address - Street 1:2385 BOWES RD STE 350
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-5501
Mailing Address - Country:US
Mailing Address - Phone:312-927-5665
Mailing Address - Fax:323-433-9177
Practice Address - Street 1:2385 BOWES RD STE 350
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5501
Practice Address - Country:US
Practice Address - Phone:312-927-5665
Practice Address - Fax:323-433-9177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty