Individual
MR. JAMES POWELL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(847) 688-1900
Mailing address
10445 W WALDO AVE, BEACH PARK, IL 60099-3668
(847) 872-0427
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
881023
WI
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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