Individual
CHARLES R ELLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
544 W PALMER ST, ARTHUR, IL 61911-1240
(217) 281-3844
(217) 353-3130
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-1255
(217) 872-0849
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-101455
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101455
—
IL
Enumeration date
12/23/2005
Last updated
05/08/2024
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