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Organization
CANCER CARE SPECIALISTS OF CENTRAL ILLINOIS, S.C
Active
Organization
CANCER CARE SPECIALISTS OF CENTRAL ILLINOIS, S.C
Active
Other names
Cancer Care Specialists of Illinois
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PERRY GUAGLIANONE MD (DIRECTOR OF PHARMACY)
(217) 876-6600
Entity
Organization
Contact information
Practice address
210 W MCKINLEY AVE STE 6, DECATUR, IL 62526-5858
(217) 329-3239
Mailing address
210 W MCKINLEY AVE STE 6, DECATUR, IL 62526-5858
(217) 329-3239
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168603
PK
—
Enumeration date
01/13/2022
Last updated
06/14/2024
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