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General NPI Number Information
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NPI Number | 1922269166
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Entity Type | Organization
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Legal Business Name | ALFRED N ROSSI MD SC
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 107 TREMONT ST
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City | HOPEDALE
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State | IL
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Zip | 61747-7525
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Country | US
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Telephone | 309-449-4450
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 267 107 TREMONT ST
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City | HOPEDALE
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State | IL
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Zip | 61747-0267
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Country | US
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Telephone | 309-449-4450
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALFRED N ROSSI
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Credential | MD
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Telephone | 309-449-4450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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