Provider Demographics
NPI:1689953838
Name:COOK RADIATION ONCOLOGY SC
Entity Type:Organization
Organization Name:COOK RADIATION ONCOLOGY SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARISH
Authorized Official - Middle Name:VRAJLAL
Authorized Official - Last Name:THAKRAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-864-3838
Mailing Address - Street 1:PO BOX 9732
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60567-0732
Mailing Address - Country:US
Mailing Address - Phone:312-864-3838
Mailing Address - Fax:312-864-9295
Practice Address - Street 1:2233 W. DIVISION STREET
Practice Address - Street 2:CANCER CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622
Practice Address - Country:US
Practice Address - Phone:312-864-3838
Practice Address - Fax:312-864-9295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-05
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360463682085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty