MEDICARE: MS. SHADON MICHELE ELLISON B.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1528303161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHADON MICHELE ELLISON B.S.

Provider Business Mailing Address
First Line	:	4820 S KING DR
Second Line	:	APT. 1S
City	:	CHICAGO
State	:	IL
Zip	:	60615-1349
Country	:	US
Telephone Number	:	312-320-2844
Fax Number	:	708-529-5868

Provider Business Practice Location Address
First Line	:	4820 S KING DR
Second Line	:	APT. 1S
City	:	CHICAGO
State	:	IL
Zip	:	60615-1349
Country	:	US
Telephone Number	:	312-320-2844
Fax Number	:	708-529-5868

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2012
Last Update Date	:	03/02/2013

Similar Medicare Providers

1639129646 — MRS. TYANN R BILLMAN PA-C
Practice Location Address:

735 E CHICAGO RD
BRONSON, MI
49028-1349

Practice Phone: 517-858-1400
Practice Fax: 517-858-1403

1629085071 — MRS. LISA ANNE KOENIGSBERG MS CCC-SLP
Practice Location Address:

1540 N LA SALLE DR , 1501
CHICAGO, IL
60610-1349

Practice Phone: 312-573-0242
Practice Fax:

1437228731 — DR. CESAR A. MORALES MD-FACP
Practice Location Address:

1349 N WESTERN AVE
CHICAGO, IL
60622-8316

Practice Phone: 773-384-8584
Practice Fax: 866-777-2763

1992863526 — CAM MEDICAL GROUP S.C.
Practice Location Address:

1349 N WESTERN AVE
CHICAGO, IL
60622-8316

Practice Phone: 773-384-8584
Practice Fax: 866-777-2763

1780870832 — CARMEN A. SIERRA M.D.,S.C.
Practice Location Address:

1349 N WESTERN AVE
CHICAGO, IL
60622-8316

Practice Phone: 773-384-8584
Practice Fax: 773-661-0921

1679749725 — ELLEN MARIE SHWATAL MS, MSPH
Practice Location Address:

1349 PRAIRIE CT
WEST CHICAGO, IL
60185-5147

Practice Phone: 630-876-8176
Practice Fax:

Directions to “ MS. SHADON MICHELE ELLISON B.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.