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General NPI Number Information
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NPI Number | 1295850329
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Entity Type | Individual
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Provider Name | THOMAS ARTHUR ROSS M.S.W.
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Gender | Male
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2530 CRAWFORD AVE SUITE 206
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City | EVANSTON
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State | IL
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Zip | 60201-4970
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Country | US
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Telephone | 847-424-0680
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Fax | 847-676-9408
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Provider Business Mailing Address
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Address Line | 9345 AVERS AVE
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City | EVANSTON
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State | IL
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Zip | 60203-1312
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Country | US
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Telephone | 847-673-1403
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Fax | 847-676-9408
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | IL
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