Provider Demographics
NPI:1952058422
Name:ONCOLOGY HEMATOLOGY ASSOCIATES OF CENTRAL ILLINOIS
Entity Type:Organization
Organization Name:ONCOLOGY HEMATOLOGY ASSOCIATES OF CENTRAL ILLINOIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PAYER RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-243-3501
Mailing Address - Street 1:110 EASTGATE DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61571-9236
Mailing Address - Country:US
Mailing Address - Phone:309-243-3016
Mailing Address - Fax:309-243-3032
Practice Address - Street 1:110 EASTGATE DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IL
Practice Address - Zip Code:61571-9236
Practice Address - Country:US
Practice Address - Phone:309-243-3016
Practice Address - Fax:309-243-3032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy