Individual
GREGORY H ELLIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2015 JACKSON ST, ANDERSON, IN 46016-4337
(765) 646-8433
(765) 683-2528
Mailing address
4095 RELIABLE PARKWAY, CHICAGO, IL 60686-0040
(314) 821-8055
(314) 821-1833
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01028194A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000085495
BCBS
IN
Enumeration date
12/09/2005
Last updated
07/08/2007
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