Ingrassia, Theodore S.

Ingrassia, Theodore S. is an individual health care provider with primary practice located at 535 Roxbury Rd Suite B600, Rockford IL 61107-5076. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Ingrassia, Theodore S. can be contacted via phone (815) 397-7212.

Contact Information

Primary practice address
535 Roxbury Rd Suite B600 Rockford IL 61107-5076
Phone: (815) 397-7212
Fax: (815) 397-2539
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 036 083892 Illinois

Profile Details

NPI number 1437263662
LBN Legal business name Ingrassia, Theodore S.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2006
Last updated May 4th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437263662 NPPES
Illinois Other 101 00686 BLUE CROSS BLUE SHIELD
Illinois MEDICAID 036 083892 BLUE CROSS BLUE SHIELD
Illinois Other 110060997 BLUE CROSS BLUE SHIELD

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