| Ms Lisa Annette Ellingwood, APRN, PMHNP-BC | |
|
1802 S Mattis Ave, Champaign, IL 61821-5923 | |
| (217) 365-2855 | |
| (217) 365-2856 |
| Full Name | Ms Lisa Annette Ellingwood |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 5 Years |
| Location | 1802 S Mattis Ave, Champaign, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083255343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 041.385774 (Illinois) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 209.020407 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| The Carle Foundation Hospital | Urbana, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Carle Health Care Incorporated | 3577515774 | 799 |
| Entity Name | Carle Health Care Incorporated |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154653947 PECOS PAC ID: 3577515774 Enrollment ID: O20100513000829 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Lisa Annette Ellingwood, APRN, PMHNP-BC 1802 S. Mattis Ave, Champaign, IL 61821 Ph: (217) 365-2855 | Ms Lisa Annette Ellingwood, APRN, PMHNP-BC 1802 S Mattis Ave, Champaign, IL 61821-5923 Ph: (217) 365-2855 |
Emily Stephenson, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1701 Curtis Rd, Champaign, IL 61822 Phone: 217-365-6207 Fax: 217-365-6380 | |
Mrs. Tiffany Ann Rushing, APN, FNP-BC, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1802 S Mattis Ave, Champaign, IL 61821 Phone: 217-365-2855 Fax: 217-365-2856 | |
Maddison P. Draper, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2718 N Prospect Ave, Champaign, IL 61822 Phone: 217-337-3852 Fax: 217-337-3853 | |
Jessica Lynn Mandrell, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 819 Bloomington Rd, Champaign, IL 61820 Phone: 217-356-1558 | |
Ms. Greta Obereiner, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1801 Windsor Rd, Champaign, IL 61822 Phone: 217-366-8130 Fax: 217-366-6106 | |
Alger Penas, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2300 S 1st St, Champaign, IL 61820 Phone: 217-383-9400 Fax: 217-383-9691 | |
Miss Abigayl Frields, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1813 W Kirby Ave Ste 120, Champaign, IL 61821 Phone: 217-383-3131 |