| Janice Takata Rossi Md Sc | |
|
1600 So Fourth Ste 140 Morton IL 61550 | |
| (309) 263-6154 | |
| (309) 263-6111 |
| Full Name | Janice Takata Rossi Md Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1600 So Fourth, Morton, Illinois |
| Authorized Official Name and Position | Janice Lourene Takata Rossi (PRESIDENT) |
| Authorized Official Contact | 3092636154 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Janice Takata Rossi Md Sc 1600 So Fourth Ste 140 Morton IL 61550 Ph: (309) 263-6154 | Janice Takata Rossi Md Sc 1600 So Fourth Ste 140 Morton IL 61550 Ph: (309) 263-6154 |
| NPI Number | 1326064296 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 12/06/2012 |
| Medicare PECOS PAC ID | 0042225872 |
|---|---|
| Medicare Enrollment ID | O20060215000062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326064296 | NPI | - | NPPES |
| 036065144 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036-065144 (Illinois) | Primary |
| Provider Name | Janice L Takata Rossi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417144577 PECOS PAC ID: 5496760225 Enrollment ID: I20060223000175 |
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