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NPI Code Detail

MEDICARE: ALFRED N ROSSI MD SC

MEDICARE: ALFRED N ROSSI MD SC
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
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1922269166
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALFRED N ROSSI MD SC
Provider Business Mailing Address
First Line : PO BOX 267
Second Line : 107 TREMONT ST
City : HOPEDALE
State : IL
Zip : 61747-0267
Country : US
Telephone Number : 309-449-4450
Fax Number :
Provider Business Practice Location Address
First Line : 107 TREMONT ST
Second Line :
City : HOPEDALE
State : IL
Zip : 61747-7525
Country : US
Telephone Number : 309-449-4450
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. ALFRED N ROSSI
Credential : MD
Telephone Number : 309-449-4450
Provider Enumeration Date : 06/20/2008
Last Update Date : 06/27/2008

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