Healthcare Provider Details

I. General information

NPI: 1346355575
Provider Name (Legal Business Name): CHRISTOPHER HAROLD ROSS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 W POLK ST 10TH FLOOR, DIVISION OF EMERGENCY MEDICINE
CHICAGO IL
60612-3723
US

IV. Provider business mailing address

1900 W POLK ST 10TH FLOOR, DIVISION OF EMERGENCY MEDICINE
CHICAGO IL
60612-3723
US

V. Phone/Fax

Practice location:
  • Phone: 312-864-0060
  • Fax: 312-864-9656
Mailing address:
  • Phone: 312-864-0060
  • Fax: 312-864-9656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036-096945
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: