MARY ELIZABETH ROSS MD PHD NPI 1841287588

NPI Information

NPI: 1841287588
Provider Name: MARY ELIZABETH ROSS, MD, PHD
Classification: Pediatrics - 2080P0207X
Entity Type: Individual

Specialization: Pediatric Hematology-Oncology

PECOS Registration: Yes

Address:
530 NE GLEN OAK AVE
PEORIA, IL
ZIP 61637
Phone: (309) 624-4945
Get Directions

Mary Elizabeth Ross, MD, PHD is a pediatric hematology-oncology pediatrics in Peoria, IL. The provider is a pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. Mary Elizabeth Ross, MD, PHD NPI is 1841287588. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

530 NE GLEN OAK AVE
PEORIA, IL
ZIP 61637
Phone: (309) 624-4945
Fax: (309) 624-9848

The NPI 1841287588 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/27/2005 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080P0207X	Pediatrics	Pediatric Hematology-Oncology	036.122072	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2534850	MEDICAID	OHIO
2	036122072	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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