Provider Demographics
NPI:1316014830
Name:NORTHWEST ONCOLOGY & HEMATOLOGY SC
Entity Type:Organization
Organization Name:NORTHWEST ONCOLOGY & HEMATOLOGY SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEIBACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-577-0620
Mailing Address - Street 1:3701 ALGONQUIN RD
Mailing Address - Street 2:SUITE 900
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-3127
Mailing Address - Country:US
Mailing Address - Phone:847-577-0620
Mailing Address - Fax:847-577-1475
Practice Address - Street 1:800 BIESTERFIELD RD
Practice Address - Street 2:SUITE 210
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3311
Practice Address - Country:US
Practice Address - Phone:847-577-0620
Practice Address - Fax:847-577-1475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042-004266207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5519440004Medicare NSC
IL698763Medicare PIN
ILCF2043Medicare PIN
IL698760Medicare PIN