| Rose Medical Association, Inc. | |
|
209 W Romeo B Garrett Ave Peoria IL 61605-2502 | |
| (309) 686-1600 | |
| (309) 686-1605 |
| Full Name | Rose Medical Association, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology - Addiction Medicine |
| Location | 209 W Romeo B Garrett Ave, Peoria, Illinois |
| Authorized Official Name and Position | Ernest C. Rose (MEDICAL DIRECTOR / CEO) |
| Authorized Official Contact | 3096861600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rose Medical Association, Inc. 209 W Romeo B Garrett Ave Peoria IL 61605-2502 Ph: (309) 686-1600 | Rose Medical Association, Inc. 209 W Romeo B Garrett Ave Peoria IL 61605-2502 Ph: (309) 686-1600 |
| NPI Number | 1144741844 |
|---|---|
| Provider Enumeration Date | 07/03/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144741844 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | 036-059239 (Illinois) | Primary |
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