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Ethan Ross
NPI 1649640996 · on the registry since 2015 · sole proprietor
Practice
- Address
- 966 S Fern Ave
Elmhurst, IL 60126 - Phone
- (630) 805-1854
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2015-09-30
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois