ALEXIS ELLSTROM (NPI# 1114560695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114560695 |
| Entity Type | Individual |
| Full Name | ALEXIS ELLSTROM |
| Credential | PAC |
| Practice Address |
5701 W 79th St Burbank IL 60459-1332 |
| Mailing Address |
1040 N Glenmore St Lockport IL 60441-2700 |
| Practice Telephone | 7084995400 |
| Mailing Telephone | 8155459592 |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2019-10-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085.007289 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5701 W 79TH ST |
| City | BURBANK |
| State | IL |
| Zip Code | 60459-1332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013937309 | Thi of Illinois At Exceptional Health, LLC | Skilled Nursing Facility | 5701 W 79th St, Burbank, IL 60459-1332 | 2006-07-20 |
| 1790327682 | Exceptional Care, LLC | Durable Medical Equipment & Medical Supplies | 5701 W 79th St, Burbank, IL 60459-1332 | 2019-10-11 |
| 1164560363 | Exceptional Care, LLC | Durable Medical Equipment & Medical Supplies | 5701 W 79th St, Burbank, IL 60459-1332 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619475852 | Albina Optometric | Optometrist | The Eye Care Center, Ltd, 8525 S Harlem Ave, Burbank, IL 60459 | 2018-01-23 |
| 1265943583 | Sara Christine De Van | Speech-Language Pathologist | 7600 South Mason Avenue, Burbank, IL 60459 | 2017-10-13 |
| 1710426465 | Nikki Negrete | Specialist/Technologist | 8520 S. Leclaire Ave., Burbank, IL 60459 | 2017-02-14 |
| 1700335734 | Sheefa Pharmacy Inc. | Pharmacy | 8519 S Harlem Avenue, Burbank, IL 60459 | 2016-10-03 |
| 1518325695 | Orthodontic Experts | Dentist | 7820 S. Cicero Ave, Burbank, IL 60459 | 2016-02-04 |
| 1528438306 | Lila Ayyad-alharsha | Behavioral Analyst | 6146 W. State Rd., Burbank, IL 60459 | 2015-10-06 |
| 1467852483 | Chicago Counseling & Training, Inc | Counselor | 4817 W. 83rd Street, Burbank Medical Center, Burbank, IL 60459 | 2014-08-27 |
| 1629344247 | Michael Joseph Fary | Optometrist | 7708 S Cicero Ave, Suite A5, Burbank, IL 60459 | 2012-03-28 |
| 1265732176 | Syeda Kulsoom Ali | Family Medicine | 4901 W 79th St Floor 2, Burbank, IL 60459 | 2010-10-26 |
| 1114119781 | Bonnes and Vasquez, P.C. | Social Worker | 13152 S. Cicero Ave, Pmb 260, Crestwood, IL 60459 | 2007-08-16 |
| Find all providers in zip 60459 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425281 | Katherine Fundora | Physician Assistant | 507 E Cypress Ave Frnt, Burbank, CA 91501-3237 | 2019-06-06 |
| 1922588649 | Rachel Leann White | Physician Assistant | 2501 W Burbank Blvd Ste 200, Burbank, CA 91505-2347 | 2018-08-21 |
| 1548715170 | Vickie Cheng | Physician Assistant | 191 S Buena Vista St Ste 475, Burbank, CA 91505-4541 | 2016-08-24 |
| 1629272307 | Frederick Noravian | Physician Assistant | 191 South Buena Vista Street, Suite 235, Burbank, CA 91505-4563 | 2007-06-14 |
| 1871703777 | Gina Napenas Obsenares | Physician Assistant | 201 S Buena Vista St Ste 420, Burbank, CA 91505-4571 | 2007-05-22 |
| 1598829434 | Kristina Karapetyan | Physician Assistant | 401 S. Glenoals Blvd, Suite 101, Burbank, CA 91502-1911 | 2006-12-21 |
| 1861495798 | Rachael C Mcafee | Physician Assistant | 191 S Buena Vista St Ste 420, Burbank, CA 91505-4551 | 2005-05-24 |
| 1720688179 | Wranga B Zadran | Physician Assistant | 2501 W Burbank Blvd, Burbank, CA 91505-2347 | 2020-10-27 |
| 1457902645 | Carina Alayne Hornbrook | Physician Assistant | 501 S Buena Vista St, Burbank, CA 91505-4809 | 2019-09-27 |
| 1073168282 | Jenny Lin | Physician Assistant | 501 S Buena Vista St, Burbank, CA 91505-4809 | 2019-08-05 |
| Find all providers in BURBANK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.