Organization
DAVID L ELLENS MD FACP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L ELLENS M.D. (PRESIDENT)
(708) 342-1573
Entity
Organization
Contact information
Practice address
6703 159TH ST STE 115, TINLEY PARK, IL 60477-1782
(708) 342-1573
Mailing address
6703 159TH ST STE 115, TINLEY PARK, IL 60477-1782
(708) 342-1573
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Enumeration date
03/22/2007
Last updated
08/22/2020
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