# ELLIS PEDIATRIC PHYSICAL THERAPY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265887491
- **Authorized official:** JULIETTE ELLIS P.T. (PHYSICAL THERAPIST)
- **Authorized official phone:** (847) 602-5016

## Contact information

- **Practice address:** 310 HAPP RD STE 310, NORTHFIELD, IL 60093-3455
- **Practice address phone:** (847) 602-5016
- **Mailing address:** 433 OAKDALE AVE, GLENCOE, IL 60022-2112
- **Mailing address phone:** (847) 602-5016

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 070008366 | IL | Yes |

## Other

- **Enumeration date:** 04/25/2016
- **Last updated:** 04/25/2016