Provider Demographics
NPI:1669643334
Name:AMERICAN CANCER CARE PC
Entity Type:Organization
Organization Name:AMERICAN CANCER CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SASIKALA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAIDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-830-5409
Mailing Address - Street 1:9301 GOLF RD
Mailing Address - Street 2:201
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1667
Mailing Address - Country:US
Mailing Address - Phone:630-830-5409
Mailing Address - Fax:630-246-6650
Practice Address - Street 1:9301 GOLF RD
Practice Address - Street 2:201
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1667
Practice Address - Country:US
Practice Address - Phone:847-390-6634
Practice Address - Fax:847-390-6072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01625384OtherBCBS
IL036089172Medicaid
IL01625384OtherBCBS
ILH11430Medicare UPIN