Individual
ANNE L ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC
Contact information
Practice address
1340 W HAMPTON PLACE, PALATINE, IL 60067
(847) 934-8244
Mailing address
1340 W HAMPTON PLACE, PALATINE, IL 60067
(847) 934-8244
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632151
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/28/2006
Last updated
07/08/2007
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