MEDICARE: DEBORAH 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
1	225X00000X	Occupational Therapist	056005790	IL

General Provider Information

NPI Number	:	1336013028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH ROSS

Provider Business Mailing Address
First Line	:	4015 N MILWAUKEE AVE UNIT 503
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-3969
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4015 N MILWAUKEE AVE UNIT 503
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-3969
Country	:	US
Telephone Number	:	630-460-6790
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2025
Last Update Date	:	10/03/2025

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Directions to “ DEBORAH ROSS ” Practice Location

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