Organization
NOMC/MACNEAL RADIATION THERAPY JOINT VENTURE, LLC
Active
Parent organization
NUCLEAR ONCOLOGY SC
Other names
d.b.a.-Berwyn Radiation Oncology Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
NUCLEAR ONCOLOGY SC
Authorized official
MR. ROGER S KRUEGER (GROUP ADMINISTRATOR)
(630) 734-9560
Entity
Organization
Contact information
Practice address
6801 34TH ST, BERWYN, IL 60402-5591
(708) 484-0011
(708) 484-0549
Mailing address
PO BOX 94, HIAWATHA, IA 52233-0094
(319) 826-3763
(888) 609-6019
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE8968
RAILROAD MEDICARE PIN
IL
Enumeration date
07/08/2006
Last updated
07/21/2022
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