| Dr. Fredrick Ellyin, Ltd | |
|
5140 N California Ave Suite 545 Chicago IL 60625-3645 | |
| (773) 275-0177 | |
| (773) 275-5431 |
| Full Name | Dr. Fredrick Ellyin, Ltd |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 5140 N California Ave, Chicago, Illinois |
| Authorized Official Name and Position | Fredrick M Ellyin (OWNER) |
| Authorized Official Contact | 7732750177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Fredrick Ellyin, Ltd 5140 N California Ave Suite 545 Chicago IL 60625-3645 Ph: (773) 275-0177 | Dr. Fredrick Ellyin, Ltd 5140 N California Ave Suite 545 Chicago IL 60625-3645 Ph: (773) 275-0177 |
| NPI Number | 1598847642 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598847642 | NPI | - | NPPES |
| 21609026 | Other | IL | BLUE SHIELD PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (Illinois) | Primary |
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