| Midwest Center For Cancer & Blood, Sc | |
|
15 W Pleasant Ave Sandwich IL 60548-1050 | |
| (815) 786-9197 | |
| (815) 786-9199 |
| Full Name | Midwest Center For Cancer & Blood, Sc |
|---|---|
| Speciality | Clinic/center |
| Location | 15 W Pleasant Ave, Sandwich, Illinois |
| Authorized Official Name and Position | Ramesh Kola (PRESIDENT) |
| Authorized Official Contact | 8157869197 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Center For Cancer & Blood, Sc 15 W Pleasant Ave Sandwich IL 60548-1050 Ph: (815) 786-9197 | Midwest Center For Cancer & Blood, Sc 15 W Pleasant Ave Sandwich IL 60548-1050 Ph: (815) 786-9197 |
| NPI Number | 1366537292 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 01/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366537292 | NPI | - | NPPES |
| 14D1047350 | Other | CLIA # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 042-618670 (Illinois) | Primary |
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