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JEFFREY LEE ELLIS MD NPI 1538698543


NPI Information

NPI: 1538698543
Provider Name: JEFFREY LEE ELLIS, MD
Classification: Urology - 208800000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2160 S 1ST AVE
MAYWOOD, IL
ZIP 60153
Phone: (708) 216-9000
Get Directions

Jeffrey Lee Ellis, MD is an urology in Maywood, IL with 7 years of experience. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. Jeffrey Lee Ellis, MD NPI is 1538698543. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2017

The provider's business location address is:

2160 S 1ST AVE
MAYWOOD, IL
ZIP 60153-328
Phone: (708) 216-9000

The NPI 1538698543 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/5/2017 and was last updated on 6/24/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208800000XUrologyMT212656PENNSYLVANIANo
2390200000XStudent in an Organized Health Care Education/Training ProgramMT212656PENNSYLVANIANo
3208800000XUrology036160253ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1MT212656OTHERPENNSYLVANIAPENNSYLVANIA STATE BOARD OF MEDICINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.