Organization
CENTRAL ILLINOIS RADIATION ONCOLOGY PHYSICIANS, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REVATHI SWAMINATHAN M.D. (OWNER)
(309) 671-8749
Entity
Organization
Contact information
Practice address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0001
(309) 672-5700
(309) 671-2774
Mailing address
108 SW MADISON AVE, PEORIA, IL 61602-1107
(309) 671-8749
(309) 671-8740
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE7037
RAILROAD GROUP NUMBER
—
Enumeration date
06/09/2006
Last updated
12/04/2007
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