Individual
MS. EMILY JANE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2900 N LAKE SHORE DR, CHICAGO, IL 60657-5640
(773) 665-3086
Mailing address
2900 N LAKE SHORE DR, CHICAGO, IL 60657-5640
(773) 665-3086
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.005076
IL
363AM0700X
Medical Physician Assistant
085.005076
IL
Other
Enumeration date
07/16/2014
Last updated
01/29/2021
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