# ROSE MEDICAL ASSOCIATION, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144741844
- **Authorized official:** DR. ERNEST C. ROSE MD (MEDICAL DIRECTOR / CEO)
- **Authorized official phone:** (309) 686-1600

## Contact information

- **Practice address:** 209 W ROMEO B GARRETT AVE, PEORIA, IL 61605-2502
- **Practice address phone:** (309) 686-1600
- **Practice address fax:** (309) 686-1605
- **Mailing address:** 209 W ROMEO B GARRETT AVE, PEORIA, IL 61605-2502
- **Mailing address phone:** (309) 686-1600
- **Mailing address fax:** (309) 686-1605

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | 036-059239 | IL | Yes |

## Other

- **Enumeration date:** 07/03/2017
- **Last updated:** 07/21/2022