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Organization
ONCOLOGY HEMATOLOGY ASSOCIATES OF CENTRAL IL, PC
Active
Organization
ONCOLOGY HEMATOLOGY ASSOCIATES OF CENTRAL IL, PC
Active
Parent organization
ONCOLOGY HEMATOLOGY ASSOCIATES OF CENTRAL IL, PC
Other names
Illinois CancerCare
Organization subpart
Yes
Provider details
NPI number
Legal business name
ONCOLOGY HEMATOLOGY ASSOCIATES OF CENTRAL IL, PC
Authorized official
JASON HARLOW PHARMD (DIRECTOR OF PHARMACY)
(309) 243-3403
Entity
Organization
Contact information
Practice address
1641 BROADWAY ST, PEKIN, IL 61554-3805
(309) 243-3014
(309) 243-3032
Mailing address
8940 N WOOD SAGE RD, PEORIA, IL 61615-7822
(309) 243-3403
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054020985
STATE LICENSE
IL
Enumeration date
11/16/2018
Last updated
11/16/2018
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