Organization
NORTHWEST INDIANA RADIATION ONCOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ABDUL WAHEED KHAN MD (VICE-PRESIDENT)
(219) 757-6285
Entity
Organization
Contact information
Practice address
1201 MAIN ST, CROWN POINT, IN 46307-2716
(708) 482-4949
(708) 482-4949
Mailing address
PO BOX 226, OLYMPIA FIELDS, IL 60461-0226
(708) 482-4949
(708) 482-4949
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
IN01030584A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100188320A
—
IN
Enumeration date
07/04/2006
Last updated
01/12/2012
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