Provider Demographics
NPI:1790813202
Name:ONCOLOGY HEMATOLOGY ASSOCIATES OF NORTHERN ILLINOIS, LTD.
Entity Type:Organization
Organization Name:ONCOLOGY HEMATOLOGY ASSOCIATES OF NORTHERN ILLINOIS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:KAPADIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-336-6111
Mailing Address - Street 1:202 S GREENLEAF ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3399
Mailing Address - Country:US
Mailing Address - Phone:847-336-6111
Mailing Address - Fax:847-336-7566
Practice Address - Street 1:202 S GREENLEAF ST
Practice Address - Street 2:SUITE E
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031
Practice Address - Country:US
Practice Address - Phone:847-336-6111
Practice Address - Fax:847-336-7566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036056326174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036077916Medicaid
IL4919949OtherBLUE CROSS BLUE SHIELD
IL036056326Medicaid
ILE18836Medicare UPIN
IL4919949OtherBLUE CROSS BLUE SHIELD
ILD14954Medicare UPIN
IL036056326Medicaid