Request an Appointment
Name
Name
*
First
Last
Date of Birth
Date of Birth
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MM
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DD
YYYY
Preferred Phone Number
Preferred Phone Number
*
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Email
*
Please indicate the date that would be your first preference for an appointment. For same day appointments, please call the clinic at which you would like to be seen.
Please indicate the date that would be your first preference for an appointment. For same day appointments, please call the clinic at which you would like to be seen.
/
MM
/
DD
YYYY
What time of day do you prefer?
What time of day do you prefer?
Morning
Afternoon
Are you a new patient?
Are you a new patient?
Yes
No
What type of blood disorder, cancer or other condition have you been diagnosed with?
Preferred Clinic Location
(see locations and addresses)
:
*
Chicago Ridge - Medical Oncology at Millennium Medical Center, First Floor
Chicago Ridge - Medical Oncology at Millennium Medical Center, Second Floor
Mokena - Radiation Oncology at Southland Oncology
Hazel Crest - Radiation Oncology at South Suburban Cancer Center
Orland Park - Medical Oncology at Great Lakes Medical Center
Affiliated Oncologists at Silver Cross - New Lenox (Medical Oncology)
Affiliated Oncologists at Hazel Crest (Oncology/Hematology)
Affiliated Oncologists at High Tech Medical Park – Palos Heights (Radiation Oncology)
Affiliated Oncologists at Advocate Christ Medical Center - Oak Lawn (Radiation Oncology)
Affiliated Oncologists at OSF Little Company of Mary Hospital - Oak Lawn (Gynecologic Oncology)
Affiliated Oncologists at Advocate Good Samaritan Hospital - Downers Grove (Gynecologic Oncology)
Preferred Provider
(see provider bios)
:
Elke Aippersback, MD, MSC
Vasia Ahmed, MD
Bassem Chaar, MD
Paul Crossan, MD
Steven Engel, MD
Corey Foster, MD, MS
Alfred Guirguis, DO, MPH
Rami Haddad, MD, FACP
Amar Hamad, MD
M. Mufaddal Hamadeh, MD
Shadi Hamdan, MD
Sarah Jeong, MD
H. Jason Kang, MD
Mouhammed Kelta, MD
Shadi Latta, MD
M. Patrick Lowe, MD
Mahmoud Mahafzah, MD, PHD, FACP
Abdullah Malas, MD
Carrie McIlwain, MD, MPH
Ronald Myint, MD
Nikki Neubauer, MD
Yunus Nomanbhoy, MD
Mauna Pandya, MD
Jayanthi Ramadurai, MD
Suby Rao, MD
Shaina Rozell, MD, MPH
Wasif Shirazi, MD
Faisal Vali, MD
Harsha Varadhi, MD
Ghassan Zalzaleh, MD
How did you hear about us?
*
Physician Referral
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