Organization
TRI COUNTY ANESTHESIA S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE J ROSSI JR. M.D. (PRESIDENT)
(309) 449-3321
Entity
Organization
Contact information
Practice address
107 TREMONT ST, HOPEDALE, IL 61747-0267
(309) 449-3321
Mailing address
PO BOX 9030, WHEELING, IL 60090-9030
(847) 495-1617
(847) 537-4866
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09019736
BLUE SHIELD
IL
01
—
CI9523
RAILROAD MEDICARE
IL
Enumeration date
10/31/2006
Last updated
01/14/2010
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