# DR. FREDRICK ELLYIN, LTD

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

## Provider details

- **NPI number:** 1598847642
- **Authorized official:** DR. FREDRICK M ELLYIN MD, FACP, FCP, FACE (OWNER)
- **Authorized official phone:** (773) 275-0177

## Contact information

- **Practice address:** 5140 N CALIFORNIA AVE, SUITE 545, CHICAGO, IL 60625-3645
- **Practice address phone:** (773) 275-0177
- **Practice address fax:** (773) 275-5431
- **Mailing address:** 5140 N CALIFORNIA AVE, SUITE 545, CHICAGO, IL 60625-3645
- **Mailing address phone:** (773) 275-0177
- **Mailing address fax:** (773) 275-5431

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | IL | Yes |

## Other

- **Enumeration date:** 10/19/2006
- **Last updated:** 04/20/2008