Ross, Mary Elizabeth

Ross, Mary Elizabeth is an individual health care provider with primary practice located at 530 Ne Glen Oak Ave , Peoria IL 61637. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as her primary health care specialty. Ross, Mary Elizabeth can be contacted via phone (309) 624-4945.

Contact Information

Primary practice address
530 Ne Glen Oak Ave Peoria IL 61637
Phone: (309) 624-4945
Fax: (309) 624-9848
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology 2080P0207X 036.122072 Illinois

Profile Details

NPI number 1841287588
LBN Legal business name Ross, Mary Elizabeth
Credentials MD, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2005
Last updated Jul 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841287588 NPPES
Ohio MEDICAID 2534850
Ohio MEDICAID 036122072

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