Organization
NORTHWESTERN RADIOLOGY ONCOLOGY ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BHARAT B. MITTAL M.D. (PRESIDENT)
(312) 926-2520
Entity
Organization
Contact information
Practice address
251 E HURON ST, GALTER PAVILLION, CHICAGO, IL 60611-2908
(312) 926-2520
(312) 926-6524
Mailing address
1730 PARK ST, SUITE 101, NAPERVILLE, IL 60563-2688
(630) 718-0200
(630) 718-0900
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02220333
BLUE CROSS / BLUE SHIELD
IL
Enumeration date
02/21/2006
Last updated
08/22/2020
Update your record
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