DR. MARIE ELLEN ELLIS (NPI# 1639631583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639631583 |
| Entity Type | Individual |
| Full Name | DR. MARIE ELLEN ELLIS |
| Credential | DO |
| Practice Address |
1775 Ballard Rd Park Ridge IL 60068-1005 |
| Practice Telephone | 8473189340 |
| Mailing Telephone | 8473189340 |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2020-03-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 125075136 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407377153 | Marie Catherine Ellis | Licensed Practical Nurse | 140 Pine Street, Hamburg, NY 14025 | 2017-07-03 |
| Street Address |
1775 BALLARD RD |
| City | PARK RIDGE |
| State | IL |
| Zip Code | 60068-1005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760483465 | Nesset Pavilion Pharmacy | Pharmacy | 1775 Ballard Rd, Park Ridge, IL 60068-1005 | 2005-08-03 |
| 1235758418 | Benjamin David Catt | Family Medicine | 1775 Ballard Rd, Park Ridge, IL 60068-1005 | 2020-04-08 |
| 1245869718 | Christopher Haansehm Kang | Student in an Organized Health Care Education/Training Program | 1775 Ballard Rd, Park Ridge, IL 60068-1005 | 2020-04-06 |
| 1992334577 | Emily Rose Temple-wood | Family Medicine | 1775 Ballard Rd, Park Ridge, IL 60068-1005 | 2020-04-05 |
| 1851920557 | Ryan Edwards | Student in an Organized Health Care Education/Training Program | 1775 Ballard Rd, Park Ridge, IL 60068-1005 | 2020-04-04 |
| 1790314805 | Kishan Patel | Internal Medicine | 1775 Ballard Rd, Park Ridge, IL 60068-1005 | 2020-04-02 |
| 1225667256 | Thomas Schmittdiel | Family Medicine | 1775 Ballard Rd, Park Ridge, IL 60068-1005 | 2020-04-02 |
| 1730718719 | Laith Yasin | Internal Medicine | 1775 Ballard Rd, Park Ridge, IL 60068-1005 | 2020-04-02 |
| 1740819747 | Misbah Razvi | Internal Medicine | 1775 Ballard Rd, Park Ridge, IL 60068-1005 | 2020-04-02 |
| 1962030254 | Sasirekha Pandravada | Internal Medicine | 1775 Ballard Rd, Park Ridge, IL 60068-1005 | 2020-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861010720 | Caitlin Marie Kompanowski | Dentist | 412 W. Talcott, Park Ridge, IL 60068 | 2020-07-08 |
| 1972142198 | Center for Authentic Living, Inc. | Counselor | 120 Main Street Suite 200, Park Ridge, IL 60068 | 2020-01-06 |
| 1306312152 | Maryann Almores Devilla | Physical Medicine & Rehabilitation | Sunrise Assisted Living, 1725 Ballard Road, Park Ridge, IL 60068 | 2018-10-19 |
| 1053808857 | Landon Ginsberg | Student in an Organized Health Care Education/Training Program | 1775 Ballard, Park Ridge, IL 60068 | 2018-04-17 |
| 1255828448 | Vera W Brink | Obstetrics & Gynecology | Parkside Professional Center, 1875 Dempster St., Ste. 330, Park Ridge, IL 60068 | 2018-04-13 |
| 1205367448 | Courtney Heim | Psychiatry & Neurology | 1875 W.dempster Street - Park Side Professional Center, Ste 470, Park Ridge, IL 60068 | 2017-03-21 |
| 1720521362 | Alexander Mylonas | Psychologist | 1400 Renaissance Dr Ste 401, Park Ridge, IL 60068 | 2016-11-30 |
| 1376090878 | Rebecca Rajasekhar | Audiologist | 1030 W. Higgins Rd., Audiology Room 6, Park Ridge, IL 60068 | 2016-09-01 |
| 1164818449 | Mohammad Taha Mustaf Taha Mustafa Sheikh | Student in an Organized Health Care Education/Training Program | 1550 North Northwest Highway Suite 107, L.m. Prasad, Md, Sc, Park Ridge, IL 60068 | 2015-04-13 |
| 1518397918 | Megan Roberts | Speech-Language Pathologist | 2240 Campus Dr., Evanston, IL 60068 | 2013-11-21 |
| Find all providers in zip 60068 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538620950 | Rebecca Wilson | Internal Medicine | Lutheran General Hospital--nesset Clinic, 1775 Ballard Rd, Park Ridge, IL 60068-1005 | 2019-03-28 |
| 1346699147 | Qais G Asmar | Internal Medicine | 1406 Lois Cort, Park Ridge, IL 60068-5072 | 2016-06-13 |
| 1396115622 | Richard Joseph Powers | Internal Medicine | 1015 S Aldine Ave, Park Ridge, IL 60068-4478 | 2015-09-29 |
| 1578983086 | Doctor Services At Home Inc | Internal Medicine | 2644 Dempster St, Ste#100, Park Ridge, IL 60068-8411 | 2014-04-23 |
| 1366748097 | Susana Salcedo Md LLC | Internal Medicine | 1600 W Dempster St Ste 120, Park Ridge, IL 60068-1171 | 2011-01-27 |
| 1689976649 | Chool Liyanapatabendi | Internal Medicine | 1875 Dempster St Ste 180, Park Ridge, IL 60068-1144 | 2010-11-24 |
| 1467765495 | Beau Mccabe Brinckerhoff | Internal Medicine | 1775 Dempster St Ste E592b, Park Ridge, IL 60068-1143 | 2010-07-19 |
| 1497083430 | Susan K Burrowes Md LLC | Internal Medicine | 1600 Dempster St Ste 120, Park Ridge, IL 60068-1171 | 2009-12-03 |
| 1891976981 | Jeffrey Theodore Brasky | Internal Medicine | 711 W Devon Ave, Park Ridge, IL 60068-4713 | 2007-11-17 |
| 1770788325 | Victor Kulichenko | Internal Medicine | 207 N Broadway, Park Ridge, IL 60068 | 2007-06-15 |
| Find all providers in PARK RIDGE | ||||
| City | PARK RIDGE |
| Zip Code | 60068 |
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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.