Organization
MACOMB ONCOLOGY INSTITUTE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE LAM YUEN (ADMINISTRATOR)
(217) 324-1100
Entity
Organization
Contact information
Practice address
401 EAST GRANT STREET, MACOMB, IL 61455
(309) 836-8400
(309) 836-8440
Mailing address
PO BOX 483, LITCHFIELD, IL 62056-0483
(217) 324-1100
(217) 324-1103
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DP0725
RAILROAD MEDICARE PTAN
IL
Enumeration date
10/23/2008
Last updated
02/09/2023
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