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Individual
JASON M ELLIS
Active
Individual
JASON M ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R9584
IA
208M00000X
Hospitalist Physician
04734
IA
208M00000X
Hospitalist Physician
Primary
36174323
IL
Other
Enumeration date
07/17/2012
Last updated
04/14/2026
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