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Individual

MICHAEL ROBIN ELLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
745 FLETCHER DR STE 301, ELGIN, IL 60123-4750
(847) 741-0398
(847) 741-0549
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-0544

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036-178348
IL
208800000X
Urology Physician
83995
WI
208800000X
Urology Physician
MD00026526
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100284309
WI
Enumeration date
02/28/2006
Last updated
01/22/2026
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