# CANCER CARE SPECIALISTS OF CENTRAL ILLINOIS, S.C

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

## Provider details

- **NPI number:** 1497406219
- **Authorized official:** DR. PERRY GUAGLIANONE MD (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (217) 876-6600

## Contact information

- **Practice address:** 210 W MCKINLEY AVE STE 6, DECATUR, IL 62526-5858
- **Practice address phone:** (217) 329-3239
- **Mailing address:** 210 W MCKINLEY AVE STE 6, DECATUR, IL 62526-5858
- **Mailing address phone:** (217) 329-3239

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336S0011X | Specialty Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 01/13/2022
- **Last updated:** 06/14/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2168603 | PK | — |