Provider Demographics
NPI:1871682674
Name:AFFILIATED CANCER SPECIALISTS PC
Entity Type:Organization
Organization Name:AFFILIATED CANCER SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEHMET
Authorized Official - Middle Name:
Authorized Official - Last Name:SIPAHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-933-9660
Mailing Address - Street 1:375 N WALL ST
Mailing Address - Street 2:SUITE P320
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901
Mailing Address - Country:US
Mailing Address - Phone:815-933-9660
Mailing Address - Fax:815-937-7968
Practice Address - Street 1:375 N WALL ST
Practice Address - Street 2:SUITE P320
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901
Practice Address - Country:US
Practice Address - Phone:815-933-9660
Practice Address - Fax:815-937-7968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RH0003X, 207RH0003X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Not Answered2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36065240Medicaid
IL36065240Medicaid