Individual
CHRISTIAN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(800) 836-7536
Mailing address
602 S WESTERN AVE APT 2SR, CHICAGO, IL 60612-4811
(215) 776-0524
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MT237504
PA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/30/2025
Last updated
05/28/2026
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