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NPI Code Detail

MEDICARE: SAVANNAH CAMELA ROSS

MEDICARE:   SAVANNAH CAMELA ROSS
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
1363LF0000XFamily Nurse Practitioner209027332IL

General Provider Information

NPI Number : 1760265862
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAVANNAH CAMELA ROSS
Provider Business Mailing Address
First Line : PO BOX 691
Second Line :
City : DANVERS
State : IL
Zip : 61732-0691
Country : US
Telephone Number : 309-825-4069
Fax Number :
Provider Business Practice Location Address
First Line : 208 E COLUMBIA ST
Second Line :
City : DANVERS
State : IL
Zip : 61732-9342
Country : US
Telephone Number : 309-825-4069
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2023
Last Update Date : 02/19/2026

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Directions to “ SAVANNAH CAMELA ROSS ” Practice Location

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