Organization
SOUTHERN ILLINOIS RADIATION ONCOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LITTLE MD (MEDICAL DIRECTOR)
(618) 985-3333
Entity
Organization
Contact information
Practice address
1400 PIN OAK DR, CARTERVILLE, IL 62918-1600
(618) 985-3333
(618) 985-1315
Mailing address
600 WEST MAIN STREET, SUITE 3, CARBONDALE, IL 62901-2604
(618) 529-3159
(618) 351-9909
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036078040
—
IL
Enumeration date
12/05/2006
Last updated
03/04/2019
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