SOUTHERN COOK RADIATION ONCOLOGY LTD (NPI# 1487635314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487635314 |
| Entity Type | Organization |
| Organization Name | SOUTHERN COOK RADIATION ONCOLOGY LTD |
| Practice Address |
2310 York St Suite M Blue Island IL 60406-2411 |
| Mailing Address |
Po Box 379 Orland Park IL 60462-0379 |
| Practice Telephone | 7083960910 |
| Practice Fax Number | 7083884354 |
| Mailing Telephone | 7084609836 |
| Mailing Fax Number | 7084601117 |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2010-07-23 |
| Authorized Official Name | DR. GREGORIO M TOLENTINO JR. (OFFICER) |
| Authorized Official Telephone | 7083960910 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS IL GR # | 1617459 | 01 |
| RR MEDICARE GR | CL9637 | 01 |
| Street Address |
2310 YORK ST SUITE M |
| City | BLUE ISLAND |
| State | IL |
| Zip Code | 60406-2411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477553188 | Robert Ethan Applebaum | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2310 York St, Suite 3a, Blue Island, IL 60406-2411 | 2005-07-22 |
| 1013292457 | Rafiq Ahmed M.d., S.c. | Clinic/Center | 2310 York St, Suite 2b, Blue Island, IL 60406-2411 | 2011-10-17 |
| 1396074753 | Sa Padua Medical Center, LLC | Family Medicine | 2310 York St, Suite 2c, Blue Island, IL 60406-2411 | 2009-12-15 |
| 1457546848 | Laurie Sue Gordon | Dentist | 2310 York St, 4b, Blue Island, IL 60406-2411 | 2007-09-10 |
| 1528079977 | Neurodiagnostic Services Ltd | Psychiatry & Neurology | 2310 York St, #2c, Blue Island, IL 60406-2411 | 2006-08-11 |
| 1154343408 | Rafiq Ahmed | Internal Medicine | 2310 York St, Suite 2b, Blue Island, IL 60406-2411 | 2006-07-24 |
| 1851330302 | William W Ashley | Internal Medicine | 2310 York St, Blue Island, IL 60406-2411 | 2006-06-06 |
| 1831145325 | Newport Medical Associates, Ltd | Internal Medicine | 2310 York St, Blue Island, IL 60406-2411 | 2006-05-26 |
| 1972558757 | Hope Medical Sc | Internal Medicine | 2310 York St, Suite 3c, Blue Island, IL 60406-2411 | 2006-05-23 |
| 1598741050 | Theodore G James | Family Medicine | 2310 York St, Ste 2c, Blue Island, IL 60406-2411 | 2005-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780205708 | Cook County | Family Medicine | 12757 S. Western Ave, Blue Island, IL 60406 | 2020-04-30 |
| 1942842810 | Blue Island Smiles PC | Dentist | 12059 Western Avenue, Blue Island, IL 60406 | 2019-10-12 |
| 1609438738 | Maisha Safford | Developmental Therapist | 2262 W. 120th Place, Blue Island, IL 60406 | 2019-06-28 |
| 1891279709 | Renjith Thomas | Physical Therapy Assistant | Therapy Department, 1546 W Water Stret, Blue Island, IL 60406 | 2018-09-18 |
| 1982182994 | Lifehouse Health Group,llc | Clinic/Center | 14127 Levitt Ave, Dixmoor, IL 60406 | 2018-08-01 |
| 1063923159 | Sarah Lynn Presser | Speech-Language Pathologist | 2975 W Broadway, Blue Island, IL 60406 | 2017-10-17 |
| 1174070676 | Aunt Martha's Youth Service Center | Clinic/Center | 12139 S. Western Ave, Blue Island, IL 60406 | 2016-09-01 |
| 1427429141 | Pamela Kilcrease | Case Manager/Care Coordinator | 2247 119th Street, Apt 6, Blue Island, IL 60406 | 2015-10-08 |
| 1639587025 | D2 Dental At Oak Street, P.C. | Dentist | 3046 West 127th Street, Blue Island, IL 60406 | 2014-07-29 |
| 1700299658 | Daniel Ahrens | Optometrist | 13114 S Western Ave, Blue Island, IL 60406 | 2014-06-09 |
| Find all providers in zip 60406 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336120807 | Gregorio M Tolentino Jr. | Radiology | 2310 York St, Suite M, Blue Island, IL 60406-2411 | 2005-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629690185 | Illinois Radiation Oncology Consultants Pllc | Radiology | 208 Flax Dr Ste 100, Highland, IL 62249-1396 | 2020-05-07 |
| 1770070609 | Brian Chou | Radiology | 2160 S 1st Ave Rm 2944, Maywood, IL 60153-3328 | 2018-04-17 |
| 1932606654 | Amishi Bajaj | Radiology | 2011 Midwest Club Pkwy, Oak Brook, IL 60523-2526 | 2018-04-09 |
| 1629502208 | Nathaniel Camden | Radiology | 500 South Paulina Street, Atrium Building, Ground Floor, Chicago, IL 60612-3833 | 2017-04-20 |
| 1811436553 | Seung Won Seol | Radiology | 251 E Huron St Ste Lc-178, Chicago, IL 60611 | 2017-02-14 |
| 1689051328 | Ross Scott Zeitlin | Radiology | 1901 W Harrison St Ste Ll-500, Chicago, IL 60612-3714 | 2015-05-01 |
| 1730578527 | Jeffrey Gross | Radiology | 6525 N Mozart St, Apt 3, Chicago, IL 60645-4377 | 2015-01-15 |
| 1508267220 | Vantage Cancer Care - Illinois, S.c. | Radiology | 17750 South Kedzie Avenue, Hazel Crest, IL 60429-2047 | 2014-09-12 |
| 1952714636 | Aditya Juloori | Radiology | 5841 S Maryland Ave # Mc9006, Chicago, IL 60637-1443 | 2014-06-10 |
| 1083047146 | Yoon Tae Kim | Radiology | 1025 Sunset Rd, Winnetka, IL 60093-3622 | 2013-08-13 |
| Find all providers with the same taxonomy | ||||
| City | BLUE ISLAND |
| Zip Code | 60406 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.