Basic Information
| Provider Information | |||||||||
| NPI: | 1881762672 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTHWEST ONCOLOGY & HEMATOLOGY, S.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3701 ALGONQUIN RD | ||||||||
| Address2: | SUITE 900 | ||||||||
| City: | ROLLING MEADOWS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600083127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475770620 | ||||||||
| FaxNumber: | 8475771545 | ||||||||
| Practice Location | |||||||||
| Address1: | 1555 BARRINGTON RD | ||||||||
| Address2: | DOCTORS BUILDING THREE, SUITE1200 | ||||||||
| City: | HOFFMAN ESTATES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601941019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475770620 | ||||||||
| FaxNumber: | 8475771545 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | LEIBACH | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8475770620 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | IL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.