Siller De La Rosa, Ricardo Andres

Siller De La Rosa, Ricardo Andres is an individual health care provider with primary practice located at 305 W Jackson St Ste 206 , Carbondale IL 62901-1474. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Siller De La Rosa, Ricardo Andres can be contacted via phone (618) 457-3006.

Contact Information

Primary practice address
305 W Jackson St Ste 206 Carbondale IL 62901-1474
Phone: (618) 457-3006
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 1558788539 Illinois

Profile Details

NPI number 1558788539
LBN Legal business name Siller De La Rosa, Ricardo Andres
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2014
Last updated Jul 17th, 2024 - about 5 months 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 1558788539 NPPES
Texas Other BP10061730 MEDICAL LICENSE

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