Individual
AMANDA RENEE ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 KISH HOSPITAL DR, DEKALB, IL 60115-9602
(815) 756-1521
Mailing address
39W865 FABYAN PKWY, ELBURN, IL 60119-9800
(630) 294-4398
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036153208
IL
207P00000X
Emergency Medicine Physician
84819
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2017
Last updated
07/17/2020
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