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Organization

COMMUNITY CANCER CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH PROSSER (EXECUTIVE DIRECTOR)
(309) 451-8500
Entity
Organization

Contact information

Practice address
407 E. VERNON AVENUE, NORMAL, IL 61761
(309) 451-8500
(309) 451-2299
Mailing address
407 E. VERNON AVENUE, NORMAL, IL 61761
(309) 451-8500
(309) 451-2231

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary

Other

Enumeration date
10/24/2011
Last updated
11/20/2013
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