Provider Demographics
NPI:1972540896
Name:RADIATION THERAPY CONSULTANTS, LTD.
Entity type:Organization
Organization Name:RADIATION THERAPY CONSULTANTS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SYED JAVED
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIRAZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-448-9393
Mailing Address - Street 1:7800 W 122ND ST
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1279
Mailing Address - Country:US
Mailing Address - Phone:708-448-9393
Mailing Address - Fax:708-448-7530
Practice Address - Street 1:7800 W 122ND ST
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1279
Practice Address - Country:US
Practice Address - Phone:708-448-9393
Practice Address - Fax:708-448-7530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1617572OtherBLUE CROSS & BLUE SHIELD
ILCD6209OtherPALMETTO GBA-RR MEDICARE
IL1617572OtherBLUE CROSS & BLUE SHIELD