Organization
ONCOLOGY SPECIALISTS SC
Active
Other names
JACOB D BITRAN MD
Organization subpart
No
Provider details
NPI number
Authorized official
SONYA N MODI PHARMD (PHARMACIST)
(847) 268-8200
Entity
Organization
Contact information
Practice address
1700 LUTHER LN, PARK RIDGE, IL 60068-1270
(847) 268-8200
(847) 723-8003
Mailing address
PO BOX 736, PARK RIDGE, IL 60068-0736
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
336012509
IL
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1478610
OTHER ID NUMBER
—
Enumeration date
06/24/2006
Last updated
07/29/2008
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