Individual
BRENDON ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5841 S MARYLAND AVE # MC3079, CHICAGO, IL 60637-1443
(773) 702-1000
Mailing address
150 HARVESTER DR STE 300, BURR RIDGE, IL 60527-5965
(773) 702-1061
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
10766520-1204
UT
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
036149973
IL
Other
Enumeration date
03/27/2014
Last updated
10/04/2019
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