# ICRC, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609187418
- **Authorized official:** CHRISTOPHER M KELLOGG MD (PARTNER)
- **Authorized official phone:** (480) 821-2838

## Contact information

- **Practice address:** 695 S DOBSON RD, CHANDLER, AZ 85224-5665
- **Practice address phone:** (480) 821-2838
- **Practice address fax:** (480) 398-8080
- **Mailing address:** PO BOX 6423, CHANDLER, AZ 85246-6423
- **Mailing address phone:** (480) 821-2838
- **Mailing address fax:** (480) 398-8080

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | Yes |
| 207RH0003X | Hematology & Oncology Physician | — | — | Yes |
| 2085N0904X | Nuclear Radiology Physician | — | NULL | — |
| 2085N0904X | Nuclear Radiology Physician | — | — | — |
| 2085R0001X | Radiation Oncology Physician | — | NULL | — |
| 2085R0001X | Radiation Oncology Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |

## Other

- **Enumeration date:** 06/25/2010
- **Last updated:** 06/25/2010