Healthcare Provider Details

I. General information

NPI: 1841282159
Provider Name (Legal Business Name): HELEN J ROSS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W HARRISON ST STE 1010
CHICAGO IL
60612-3845
US

IV. Provider business mailing address

1725 W HARRISON ST STE 1010
CHICAGO IL
60612-3845
US

V. Phone/Fax

Practice location:
  • Phone: 800-226-2371
  • Fax:
Mailing address:
  • Phone: 800-226-2371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number37521
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number37521
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberG56415
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD20795
License Number StateOR
# 5
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number036164755
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: