Individual
CAREY EUGENE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
920 MILWAUKEE AVE, LINCOLNSHIRE, IL 60069-3839
(847) 866-7846
Mailing address
NORTHSHORE MEDICAL GROUP, 2650 RIDGE AVE. SUITE 1223, EVANSTON, IL 60201-1700
(847) 982-6710
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036110022
IL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036-110022
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36110022
—
IL
Enumeration date
08/04/2006
Last updated
08/16/2023
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