MRS. KELLEY ELLIS (NPI# 1790322576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790322576 |
| Entity Type | Individual |
| Full Name | MRS. KELLEY ELLIS |
| Credential | MSN, APRN, CPNP-AC |
| Practice Address |
225 E Chicago Ave # 22 Chicago IL 60611-2991 |
| Mailing Address |
1224 Snyder Ave Ann Arbor MI 48103-5328 |
| Practice Telephone | 3122274922 |
| Practice Fax Number | 3122279646 |
| Mailing Telephone | 2487628334 |
| Enumeration Date | 2019-11-29 |
| Last Update Date | 2019-11-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
209.020528 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073622858 | Kelley D Ellis | Registered Nurse | 1900 Mistletoe Blvd Ste 200, Fort Worth, TX 76104-4049 | 2006-08-29 |
| Street Address |
225 E CHICAGO AVE # 22 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60611-2991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063669752 | Michael C Monge | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 225 E Chicago Ave # 22, Cardiovascular Surgery, Chicago, IL 60611-2991 | 2008-08-25 |
| 1922525898 | Courtney Marie Celani | Nurse Practitioner | 225 E Chicago Ave # 22, Chicago, IL 60611-2991 | 2017-08-23 |
| 1265713937 | Monica M Herron | Physician Assistant | 225 E Chicago Ave # 22, Chicago, IL 60611-2991 | 2011-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1134735962 | Kalvin Cheuk Hang Lung | Student in an Organized Health Care Education/Training Program | 675 N St Clair St 17th Floor, Chicago, IL 60611 | 2020-09-17 |
| 1487267845 | Ashley Marie Sablich | Student in an Organized Health Care Education/Training Program | 250 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2020-08-26 |
| 1245854033 | Danielle Humphrey | Student in an Organized Health Care Education/Training Program | Pa Program, Suite 1-200, 240 East Huron Street, Chicago, IL 60611 | 2020-06-08 |
| 1801418074 | Sana Healing Collective | Clinic/Center | 405 N. Wabash Street, Chicago, IL 60611 | 2020-05-11 |
| 1194359489 | Insight:eating Disorders, Weight Management & Psychological Centers | Psychiatric Hospital | 1 E. Erie Street, 4th Floor, Chicago, IL 60611 | 2020-02-26 |
| 1902439193 | Iwona Boska | Nurse Practitioner | 676 N St.clair Street, Suite 2140, Chicago, IL 60611 | 2020-02-17 |
| 1922643576 | Sarah Elizabeth Schwartzer | Audiologist | Chicago Dizziness and Hearing, 645 North Michigan Avenue, Suite 410, Chicago, IL 60611 | 2019-11-07 |
| 1023668852 | Anne Marguerite Davidson | Student in an Organized Health Care Education/Training Program | Mcgraw Medical Center, 240 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2019-09-13 |
| 1871141085 | Coast Management | Durable Medical Equipment & Medical Supplies | 40 E. Chicago Ave, Suite 149, Chicago, IL 60611 | 2019-08-30 |
| Find all providers in zip 60611 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669937231 | Colleen Ann Larkin | Nurse Practitioner | 10939 S Troy St, Chicago, IL 60655-2211 | 2019-02-07 |
| 1487160586 | Meghan Doepke Sullivan | Nurse Practitioner | 1030 N Clark St Ste 400, Chicago, IL 60610-5468 | 2017-12-27 |
| 1366955940 | Debra Chana Goldstein | Nurse Practitioner | 2732 W Chase Ave, Chicago, IL 60645-1313 | 2017-11-06 |
| 1588189260 | Larissa Marie Schulze | Nurse Practitioner | 737 N Michigan Ave Ste 820, Chicago, IL 60611-6659 | 2017-08-03 |
| 1164887295 | Meredith Murphy Mcintee | Nurse Practitioner | 5841 S Maryland Ave # Mc4065, Chicago, IL 60637-1443 | 2015-12-16 |
| 1215345442 | Tara Seider | Nurse Practitioner | 2707 W Ainslie St, Unit #3, Chicago, IL 60625-2715 | 2014-07-31 |
| 1447697982 | Emily Thurn | Nurse Practitioner | 225 E Chicago Ave Box 29, Chicago, IL 60611-2605 | 2013-05-23 |
| 1518231505 | Julianne Deschler Bertalmio | Nurse Practitioner | 1460 N. Halsted Street, Suite 402, Chicago, IL 60642 | 2012-03-08 |
| 1932478765 | Julie Elizabeth Martin | Nurse Practitioner | 225 E Chicago, 4 Ne, Chicago, IL 60611-2605 | 2011-12-22 |
| 1245532480 | Alexandra Wilson Benz | Nurse Practitioner | 225 E Chicago Ave # 93, Chicago, IL 60611-2991 | 2010-11-20 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.