Provider Demographics
NPI:1508195413
Name:SURGICAL ONCOLOGISTS PC
Entity Type:Organization
Organization Name:SURGICAL ONCOLOGISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GIANLUCA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZZARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-643-0811
Mailing Address - Street 1:100 E BELLEVUE PL
Mailing Address - Street 2:19B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-1157
Mailing Address - Country:US
Mailing Address - Phone:312-643-0811
Mailing Address - Fax:312-643-0811
Practice Address - Street 1:100 E BELLEVUE PL
Practice Address - Street 2:19B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-1157
Practice Address - Country:US
Practice Address - Phone:312-643-0811
Practice Address - Fax:312-643-0811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-24
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty