Individual
DAVID H ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
602 W. UNIVERSITY AVENUE, OPHTHALMOLOGY/OPTOMETRY, URBANA, IL 61801
(217) 383-3150
(217) 383-4845
Mailing address
P.O. BOX 6002, URBANA, IL 61803-6002
(217) 326-8300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
46007963
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0533210001
DMERC
IL
01
—
410021583
RAILROAD
IL
05
—
6447860011
—
IL
Enumeration date
09/02/2006
Last updated
06/05/2012
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