Individual
JONATHAN H ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1725 W HARRISON ST STE 710, CHICAGO, IL 60612
(312) 942-3034
Mailing address
1725 W HARRISON ST STE 710, CHICAGO, IL 60612-3863
(312) 942-3034
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036-110209
IL
2088P0231X
Pediatric Urology Physician
036-110209
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015632900004
—
PA
05
—
0892066
—
OH
01
—
423827
WELLCARE
OH
01
—
P00829965
MEDICARE RAILROAD
OH
Enumeration date
04/20/2006
Last updated
03/29/2022
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