JAMIE ELLINGWOOD (NPI# 1952544488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952544488 |
| Entity Type | Individual |
| Full Name | JAMIE ELLINGWOOD |
| Credential | PA |
| Practice Address |
1300 W Devon Ave Chicago IL 60660-1302 |
| Practice Telephone | 7737517850 |
| Practice Fax Number | 7733384049 |
| Mailing Telephone | 7737517850 |
| Mailing Fax Number | 7733384049 |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2014-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085.004875 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1300 W DEVON AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60660-1302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922055151 | Jay Hirsh Mayefsky | Pediatrics | 1300 W Devon Ave, Heartland Health Centers, Chicago, IL 60660-1302 | 2006-05-31 |
| 1184265597 | Bonita Richardson | Social Worker | 1300 W Devon Ave, Chicago, IL 60660-1302 | 2019-10-07 |
| 1033767736 | Nadia Abbasi-kling | Nurse Practitioner | 1300 W Devon Ave, Chicago, IL 60660-1302 | 2019-08-27 |
| 1609289883 | Heartland I Nternational Health Center | Clinic/Center | 1300 W Devon Ave, Chicago, IL 60660-1302 | 2014-06-05 |
| 1326460601 | Ganka Skerleva | Nurse Practitioner | 1300 W Devon Ave, Chicago, IL 60660-1302 | 2014-01-06 |
| 1013201375 | Emma Rodewald Daisy | Family Medicine | 1300 W Devon Ave, Chicago, IL 60660-1302 | 2011-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225672280 | Alexis Shelton | Behavior Technician | 6317 N Broadway, Chicago, IL 60660 | 2019-11-03 |
| 1912470105 | Pipeline - Lakefront Medical Associates, LLC | Family Medicine | 6201 North Broadway, Chicago, IL 60660 | 2019-01-10 |
| 1417492224 | Aynur Fataliyeva | Non-emergency Medical Transport (VAN) | 5701 N Sheridan Road, Apt 20g, Chicago, IL 60660 | 2017-01-03 |
| 1285187591 | Bryan Moles | Developmental Therapist | 6157 N Kenmore, Apt #4s, Chicago, IL 60660 | 2016-08-03 |
| 1144609181 | Ebm Consulting LLC | Anesthesiology | 5600 N Sheridan Road, #115, Chicago, IL 60660 | 2015-05-22 |
| 1295134112 | Brent E Agran, Dds, LLC | Dentist | 5820 N. Clark St., 1s, Chicago, IL 60660 | 2014-08-15 |
| 1538573258 | Emily Eaton | Student in an Organized Health Care Education/Training Program | 5643 N. Magnolia Ave, Chicago, IL 60660 | 2014-06-20 |
| 1538572664 | Rozina Altaf Virani | Nurse Practitioner | 6033 N Sheridan Rd Ste N6, Chicago, IL 60660 | 2014-06-05 |
| 1548673866 | Emily Mckernan | Social Worker | 5710 N Broadway Ave, Chicago, IL 60660 | 2014-06-04 |
| 1679902324 | Christopher Burgess | Psychologist | 1554 W Hollywood, #storefront, Chicago, IL 60660 | 2013-11-04 |
| Find all providers in zip 60660 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470709 | Bryan Ying Wong | Physician Assistant | 3420 S Morgan St Apt 2e, Chicago, IL 60608-6904 | 2020-09-04 |
| 1245858117 | Emily Victoria Headley | Physician Assistant | 1431 N Western Ave Ste 134, Chicago, IL 60622-1797 | 2020-07-08 |
| 1548884547 | Crystal Afua Amoah | Physician Assistant | 1665 N Orchard St Apt 104, Chicago, IL 60614-5385 | 2020-06-04 |
| 1841814274 | Zubair Aslam Khan | Physician Assistant | 3037 W Wilson Ave Apt 2w, Chicago, IL 60625-4345 | 2020-06-01 |
| 1659991818 | Taylor Nicole Anderson | Physician Assistant | 25 W Randolph St Apt 603, Chicago, IL 60601-3514 | 2020-04-17 |
| 1720616444 | Melanie Doretti | Physician Assistant | 3052 N Seminary Ave Apt 2r, Chicago, IL 60657-6788 | 2020-03-29 |
| 1154958544 | Joerissa Gearlds | Physician Assistant | 5645 W Addison St Rm 353, Chicago, IL 60634-4403 | 2020-03-25 |
| 1932736816 | Taylor Evan Fisher | Physician Assistant | 3033 N Sheridan Rd Apt 301, Chicago, IL 60657-5578 | 2020-03-23 |
| 1285260844 | Krista A Saum | Physician Assistant | 661 W Sheridan Rd Apt 601, Chicago, IL 60613-3311 | 2020-03-16 |
| 1386278430 | Adara Simonelli | Physician Assistant | 6317 S Lorel Avenue, Chicago, IL 60638 | 2020-02-27 |
| 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.