Organization
HEMATOLOGY ONCOLOGY ASSOCIATES OF ILLINOIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICK T PEREZ (STATE BUSINESS ADMINISTRATOR)
(847) 585-7012
Entity
Organization
Contact information
Practice address
676 N ST CLAIR, SUITE 2140, CHICAGO, IL 60611
(312) 664-5400
(312) 664-5854
Mailing address
25068 NETWORK PL, CHICAGO, IL 60673-1250
(847) 585-7000
(847) 240-9093
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1616101
BCBS
IL
Enumeration date
03/31/2006
Last updated
08/20/2012
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