Ellis J Talbert, Md Sc | |
7000 S Adams St Suite 240 Willowbrook IL 60527-8453 | |
(630) 986-5106 | |
(630) 986-5119 |
Full Name | Ellis J Talbert, Md Sc |
---|---|
Speciality | Family Medicine |
Location | 7000 S Adams St, Willowbrook, Illinois |
Authorized Official Name and Position | Ellis Jay Talbert (OWNER) |
Authorized Official Contact | 6309865106 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Ellis J Talbert, Md Sc 7000 S Adams St Suite 240 Willowbrook IL 60527-8453 Ph: (630) 986-5106 | Ellis J Talbert, Md Sc 7000 S Adams St Suite 240 Willowbrook IL 60527-8453 Ph: (630) 986-5106 |
NPI Number | 1114107976 |
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Provider Enumeration Date | 11/09/2007 |
Last Update Date | 07/08/2013 |
Medicare PECOS PAC ID | 5294780995 |
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Medicare Enrollment ID | O20050315001070 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114107976 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 036076981 (Illinois) | Primary |
Provider Name | Ellis J Talbert |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1538257886 PECOS PAC ID: 6002861705 Enrollment ID: I20050315001081 |
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