Individual
JAMIE ELLINGWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1300 W DEVON AVE, CHICAGO, IL 60660-1302
(773) 751-7850
(773) 338-4049
Mailing address
1300 W DEVON AVE, CHICAGO, IL 60660-1302
(773) 751-7850
(773) 338-4049
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.004875
IL
Other
Enumeration date
04/14/2009
Last updated
09/05/2014
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