Organization
CANCER CARE SPECIALISTS OF CENTRAL ILLINOIS, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN D FLOYD MD (PRESIDENT)
(618) 416-7970
Entity
Organization
Contact information
Practice address
210 W MCKINLEY AVE, SUITE 1, DECATUR, IL 62526-5858
(217) 876-6600
(217) 876-6606
Mailing address
210 W MCKINLEY AVE, SUITE 1, DECATUR, IL 62526-5858
(217) 876-6600
(217) 876-6606
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
042005607
IL
2085R0001X
Radiation Oncology Physician
042005607
IL
332B00000X
Durable Medical Equipment & Medical Supplies
042005607
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005815189
BLUE CROSS/BLUE SHIELD OF
IL
Enumeration date
10/03/2005
Last updated
07/31/2024
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