Individual
JOSEPH E ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1221 E STATE ST, ROCKFORD, IL 61104-2231
(815) 972-1000
(815) 972-1086
Mailing address
1601 PARKVIEW AVENUE, CREDENTIALING S200C, ROCKFORD, IL 61107-2231
(815) 395-5861
(815) 395-5575
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036060712
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036060712
—
IL
Enumeration date
06/30/2006
Last updated
11/02/2023
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