Mrs. Debora Ellis
Nurse Practitioner - Psychiatric/Mental Health
12251 S 80th Ave
Palos Heights
, Illinois 60463-1256
Mrs. Debora Ellis
Nurse Practitioner - Psychiatric/Mental Health
12251 S 80th Ave
Palos Heights
, Illinois 60463-1256
(708) 923-5018
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About
Features
Specialties
- Nurse Practitioner - Psychiatric/Mental Health
Languages spoken
- English
Location
First Address
- Mrs. Debora Ellis
- 12251 S 80th Ave Suite 1630
- Palos Heights, IL
- Zip : 60463-1256
- Fax : (708) 923-5018
- Phone : (708) 923-5173
Second Address
- Mrs. Debora Ellis
- 12251 S 80th Ave
- Palos Heights, IL
- Zip : 60463-1256
- Fax : (708) 923-7888
- Phone : (708) 923-7878
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 277.000609 | IL |
National Provider Identifier
| NPI | 1003352196 |
|---|---|
| Provider Name | Mrs. Debora Ellis |
| First Address | Palos Heights, IL 60463-1256 |
| Second Address | Palos Heights, IL 60463-1256 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/01/2017 |
| Last Update Date | 13/05/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.