National Provider Identifier Database

ROSE MEDICAL ASSOCIATION INC
Addiction Medicine

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine


Contact Information

ROSE MEDICAL ASSOCIATION, INC.
209 W ROMEO B GARRETT AVE
PEORIA, IL61605-2502
Phone: 309-686-1600
Fax: 309-686-1605
Website:
Specialty Taxonomy Code
* Addiction Medicine 2084A0401X

* Indicates primary specialty

NPI Profile & details for ROSE MEDICAL ASSOCIATION, INC.

NPI Number 1144741844
Legal business name
LBN
ROSE MEDICAL ASSOCIATION, INC.
Authorized official ERNEST ROSE - (MEDICAL DIRECTOR / CEO)
Entity Organization
Organization subpart No
Enumeration date 07/03/2017
Last updated 07/21/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • IL License #: 036-059239

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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