Individual
DR. ROSS VAN DORPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
351 DELNOR DR, SUITE 100, GENEVA, IL 60134-4220
(630) 232-0280
(630) 232-3895
Mailing address
351 DELNOR DR, SUITE 100, GENEVA, IL 60134-4220
(630) 232-0280
(630) 232-3895
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036097067
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036097067
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147056
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
P00944851
RR MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
10/03/2005
Last updated
01/07/2014
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