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NPI Code Detail

MEDICARE: DR. ANTONIO ROSSI DMD

MEDICARE:  DR. ANTONIO  ROSSI  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist019031143IL

General Provider Information

NPI Number : 1457889818
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTONIO ROSSI DMD
Provider Business Mailing Address
First Line : 3315 KRENN AVE
Second Line :
City : HIGHLAND PARK
State : IL
Zip : 60035-1225
Country : US
Telephone Number : 847-830-7475
Fax Number :
Provider Business Practice Location Address
First Line : 1556 S MICHIGAN AVE STE 110
Second Line :
City : CHICAGO
State : IL
Zip : 60605-1938
Country : US
Telephone Number : 312-588-0043
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2017
Last Update Date : 05/30/2017

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Directions to “ DR. ANTONIO ROSSI DMD” Practice Location

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