Individual
MR. EDWARD C ELLIOTT II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 W. MCKINLEY AVE, STE 1, DECATUR, IL 62526
(217) 876-6600
(217) 876-6606
Mailing address
210 W. MCKINLEY AVE, STE 1, DECATUR, IL 62526
(217) 876-6600
(217) 876-6606
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
036078735
IL
2085R0001X
Radiation Oncology Physician
Primary
036-078735
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-078735
—
IL
05
—
036078735
—
IL
Enumeration date
04/07/2006
Last updated
07/01/2015
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