# ONCOLOGY-HEMATOLOGY ASSOCIATES OF CENTRAL ILLINOIS P C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Illinois Cancer Care PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053463059
- **Authorized official:** JASON HARLOW PHARMD (PHCY MGER,AO)
- **Authorized official phone:** (309) 243-3404

## Contact information

- **Practice address:** 8940 N WOOD SAGE RD, PEORIA, IL 61615-7822
- **Practice address phone:** (309) 243-3405
- **Practice address fax:** (309) 243-3075
- **Mailing address:** 8940 N WOOD SAGE RD, PEORIA, IL 61615-7822
- **Mailing address phone:** (309) 243-3405
- **Mailing address fax:** (309) 243-3075

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054016528 | IL | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 01/18/2007
- **Last updated:** 02/21/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1053463059 | — | IL |
| 01 | — | 2133812 | PK | — |