Individual
DR. JOHN RICHARD ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
22 BLAINE ST, HINSDALE, IL 60521-4209
(630) 323-0061
(630) 323-0089
Mailing address
22 BLAINE ST, HINSDALE, IL 60521-4209
(630) 323-0061
(630) 323-0089
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
08/03/2006
Last updated
07/08/2007
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