| Mr Edward C Elliott Ii, MD | |
|
210 W. Mckinley Ave, Ste 1, Decatur, IL 62526 | |
| (217) 876-6600 | |
| (217) 876-6606 |
| Full Name | Mr Edward C Elliott Ii |
|---|---|
| Gender | Male |
| Speciality | Radiology - Radiation Oncology |
| Location | 210 W. Mckinley Ave, Decatur, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790748119 | NPI | - | NPPES |
| 036-078735 | Medicaid | IL | |
| 036078735 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0001X | Radiology - Radiation Oncology | 036-078735 (Illinois) | Primary |
| 207RX0202X | Internal Medicine - Medical Oncology | 036078735 (Illinois) | Secondary |
| Entity Name | Cancer Care Specialists Of Central Illinois Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871580142 PECOS PAC ID: 5991619116 Enrollment ID: O20031113000022 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Edward C Elliott Ii, MD 210 W. Mckinley Ave, Ste 1, Decatur, IL 62526 Ph: (217) 876-6600 | Mr Edward C Elliott Ii, MD 210 W. Mckinley Ave, Ste 1, Decatur, IL 62526 Ph: (217) 876-6600 |
Dr. Jeffrey Marc Boorstein, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2300 N Edward St, Decatur, IL 62526 Phone: 217-876-2300 Fax: 217-876-6725 | |
Soman Nair, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 1800 E Lake Shore Dr, Decatur, IL 62521 Phone: 217-464-2984 Fax: 217-464-1631 | |
Harold A Yoon, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 210 W Mckinley Ave Ste 1, Decatur, IL 62526 Phone: 217-877-9442 Fax: 217-233-1670 | |
Mrs. Mary Anne Depaz, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 210 W. Mckinley Ave, Ste 2, Decatur, IL 62526 Phone: 217-876-6600 Fax: 217-876-6606 | |
Dr. Renata Charissa Moore, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1990 E Lake Shore Dr, Decatur, IL 62521 Phone: 217-464-2900 Fax: 217-464-2909 | |
Dr. Mark A Muscato, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2300 N Edward St, Decatur, IL 62526 Phone: 217-876-2300 Fax: 217-876-6725 |