Provider Demographics
NPI:1700094745
Name:TRI-COUNTY RADIATION ONCOLOGY LLC
Entity Type:Organization
Organization Name:TRI-COUNTY RADIATION ONCOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEEDIPALLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-323-6766
Mailing Address - Street 1:PO BOX 3097
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60522-3097
Mailing Address - Country:US
Mailing Address - Phone:630-323-6766
Mailing Address - Fax:630-214-2069
Practice Address - Street 1:2000 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-7222
Practice Address - Country:US
Practice Address - Phone:630-978-5750
Practice Address - Fax:630-214-2069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
12962539759OtherNPI NUMBER
1205844958OtherNPI NUMBER