Organization
MIDWEST CENTER FOR CANCER & BLOOD, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMESH KOLA MD (PRESIDENT)
(815) 786-9197
Entity
Organization
Contact information
Practice address
15 W PLEASANT AVE, SANDWICH, IL 60548-1050
(815) 786-9197
(815) 786-9199
Mailing address
15 W PLEASANT AVE, SANDWICH, IL 60548-1050
(815) 786-9197
(815) 786-9199
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
042-618670
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D1047350
CLIA #
—
Enumeration date
10/04/2006
Last updated
01/11/2013
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