Mrs Kelly Elizabeth Ellis, APN, CNM in Berwyn, IL - Medicare Advanced Practice Midwife

Mrs Kelly Elizabeth Ellis, APN, CNM is a medicare enrolled "Advanced Practice Midwife" in Berwyn, Illinois. Her current practice location is 6201 Roosevelt Rd, Berwyn, Illinois. You can reach out to her office (for appointments etc.) via phone at (708) 386-0845.

Mrs Kelly Elizabeth Ellis is licensed to practice in Illinois (license number 209008508) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1962705103.

Contact Information

	Mrs Kelly Elizabeth Ellis, APN, CNM
	6201 Roosevelt Rd, Berwyn, IL 60402-1108
	(708) 386-0845
	(708) 386-8472

Map and Direction

Provider's Profile

Full Name	Mrs Kelly Elizabeth Ellis
Gender	Female
Speciality	Advanced Practice Midwife
Location	6201 Roosevelt Rd, Berwyn, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1962705103
Provider Enumeration Date: 12/09/2010
Last Update Date: 12/23/2019

Medicare PECOS Information:

PECOS PAC ID: 7719123330
Enrollment ID: I20130425000671

Medical Identifiers

Medical identifiers for Mrs Kelly Elizabeth Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1962705103	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367A00000X	Advanced Practice Midwife	209008508 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Kelly Elizabeth Ellis allows following entities to bill medicare on her behalf.

Entity Name	Pcc Community Wellness Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1871516799 PECOS PAC ID: 1557270139 Enrollment ID: O20040206000415

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Kelly Elizabeth Ellis is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Kelly Elizabeth Ellis, APN, CNM 6201 Roosevelt Rd, Berwyn, IL 60402-1108 Ph: (708) 386-0845	Mrs Kelly Elizabeth Ellis, APN, CNM 6201 Roosevelt Rd, Berwyn, IL 60402-1108 Ph: (708) 386-0845

Reviews and Comments

Advanced Practice Midwife Nurses in Berwyn, IL

Katherine E Herold, APN Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845 Fax: 708-386-8472
Tera Martin, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845 Fax: 708-386-8472
Danielle Kraessig, CNM Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845 Fax: 708-386-8472
Annette R Payot, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845 Fax: 708-386-8472
Katherine Malone Wehrmann, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845
Sydney Elizabeth Lammers, CNM, APRN Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845
Lorna Davis, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845

Mrs Kelly Elizabeth Ellis, APN, CNM - Medicare Advanced Practice Midwife in Berwyn, IL