Individual
ETHAN ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
966 S FERN AVE, ELMHURST, IL 60126-5307
(630) 805-1854
Mailing address
966 S FERN AVE, ELMHURST, IL 60126-5307
(630) 805-1854
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003466
IL
Other
Enumeration date
09/30/2015
Last updated
09/30/2015
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