Active NPI
Paul Michael Ross, M.D.
- Obstetrics & Gynecology Physician
- Glen Ellyn, IL
National Provider Identifier
1215180641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 036-055553
- Practice address
- 80 Sunset Ave
Glen Ellyn, IL 60137-5636 - Phone
- (630) 309-7751
- Fax
- (630) 858-8710
- NPI assigned
- Oct 29, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 036-055553 | IL | Primary |
Addresses
Primary practice location
80 Sunset Ave
Glen Ellyn, IL 60137-5636
Mailing address
80 Sunset Ave
Glen Ellyn, IL 60137-5636
Phone (630) 309-7751
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-055553 | IL | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225238400000",
"number": "1215180641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 SUNSET AVE",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601375636",
"telephone_number": "630-309-7751",
"fax_number": "630-858-8710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 SUNSET AVE",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601375636",
"telephone_number": "630-309-7751",
"fax_number": "630-858-8710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "PAUL",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-29",
"last_updated": "2008-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "036-055553",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Ellyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.