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Individual

LAWRENCE J ROSSI JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
107 TREMONT ST, BOX 267, 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
036057828
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036057828 5
IL
01
050036797
RAILROAD MEDICARE
IL
01
09019736
BLUE SHIELD
IL
Enumeration date
10/31/2006
Last updated
07/08/2007
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